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Predicting visual acuity with machine learning in treated ocular trauma patients

International Journal of Ophthalmology(English edition) 2023年第7期16卷 1005-1014页

作者： Zhi-Lu Zhou Yi-Fei Yan Jie-Min Chen Rui-Jue Liu Xiao-Ying Yu Meng Wang Hong-Xia Hao Dong-Mei Liu Qi Zhang Jie Wang Wen-Tao Xia Department of Forensic Medicine Guizhou Medical UniversityGuiyang 550009Guizhou ProvinceChina Shanghai Key Laboratory of Forensic Medicine Shanghai Forensic Service PlatformInstitute of Forensic ScienceMinistry of JusticeShanghai 200063China The SMART(Smart Medicine and AI-based Radiology Technology)Lab Shanghai Institute for Advanced Communication and Data ScienceShanghai UniversityShanghai 200444China School of Communication and Information Engineering Shanghai UniversityShanghai 200444China Basic Medical College Jiamusi UniversityJiamusi 154007Heilongjiang ProvinceChina

AIM:To predict best-corrected visual acuity(BCVA)by machine learning in patients with ocular trauma who were treated for at least 6mo.METHODS:The internal dataset consisted of 850 patients with 1589 eyes and an average age of 44.29y.The initial visual acuity was 0.99 log MAR.The test dataset consisted of 60 patients with 100 eyes collected while the model was optimized.Four different machine-learning algorithms(Extreme Gradient Boosting,support vector regression,Bayesian ridge,and random forest regressor)were used to predict BCVA,and four algorithms(Extreme Gradient Boosting,support vector machine,logistic regression,and random forest classifier)were used to classify BCVA in patients with ocular trauma after treatment for 6mo or longer.Clinical features were obtained from outpatient records,and ocular parameters were extracted from optical coherence tomography images and fundus photographs.These features were put into different machine-learning models,and the obtained predicted values were compared with the actual BCVA values.The best-performing model and the best variable selected were further evaluated in the test dataset.RESULTS:There was a significant correlation between the predicted and actual values[all Pearson correlation coefficient(PCC)>0.6].Considering only the data from the traumatic group(group A)into account,the lowest mean absolute error(MAE)and root mean square error(RMSE)were 0.30 and 0.40 log MAR,respectively.In the traumatic and healthy groups(group B),the lowest MAE and RMSE were 0.20 and 0.33 log MAR,respectively.The sensitivity was always higher than the specificity in group A,in contrast to the results in group B.The classification accuracy and precision were above 0.80 in both groups.The MAE,RMSE,and PCC of the test dataset were 0.20,0.29,and 0.96,respectively.The sensitivity,precision,specificity,and accuracy of the test dataset were 0.83,0.92,0.95,and 0.90,respectively.CONCLUSION:Predicting BCVA using machine-learning models in patients with treated ocular trauma is accurate and helpful

关键词： ocular trauma predicting visiual acuity best-corrected visual acuity visual dysfunction machine learning

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Comparison of ocular trauma between normalized and the COVID-19 epidemic periods in China:a multi-center cross-sectional study

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International Journal of Ophthalmology(English edition) 2023年第1期16卷 10-15页

作者： Ya-Xin Zhang Kang Feng Meng-Yu Liao Hua Yan Department of Ophthalmology Tianjin Medical University General HospitalTianjin 300052China Department of Ophthalmology Peking University Third HospitalBeijing 100191China Tianjin Medical University Tianjin 300070China

AIM:To compare the feature of ocular trauma between normalized period and the COVID-19 epidemic period in China,and to provide a profile for eye injuries in special times in future.METHODS:This is a multi-center cross-sectional study with 30 participated hospitals involving the China ocular trauma Society members.All hospitalized cases who visited the Ophthalmology Department in participated hospitals with eye injuries during the normalized period(2019)and the COVID-19 epidemic period(2020)were included in this study.Demographic characteristic of cases,date of injury,sites and types of injury were collected.RESULTS:This study involved 13525(61 cases with both eyes)injured cases.There were 7269(53.74%)eyeinjured cases and 6256(46.26%)eye-injured cases in 2019 and 2020 separately.Compared with 2019,the incidence of ocular trauma in retirees,housewives and unemployed increased with year-on-year of 4.96%,102.67%,and 11.64%among all occupations.In 2020,the incidence of eye injuries decreased in all injury sites except for an increase in home(30.29%year-on-year).The incidence of mechanical eye injuries decreased,while that of nonmechanical eye injuries(chemical/thermal/radiation)increased(47.45%year-on-year).There were 255(3.51%,255/7269)and 376(6.01%,376/6256)non-mechanical injured cases in 2019 and 2020(Pearson Chi^(2)=47.33,Pocular trauma decrease but the proportion of non-mechanical ocular trauma increase.Penetrating is still the highest proportion among all types of mechanical ocular trauma.From a preventive point of view,protection for retired persons,housewives and unemployed persons should be improved during public health events period.

关键词： ocular trauma non-mechanical eye injuries incidence COVID-19 epidemiology

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COVID-19 pandemic impact on ocular trauma in a tertiary hospital

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International Journal of Ophthalmology(English edition) 2023年第1期16卷 16-21页

作者： You-Mei Xu Li-Ping Du Ya-Dan Huo Guang-Qi An Xue-Min Jin Peng-Yi Zhou The Academy of Medical Sciences Zhengzhou UniversityZhengzhou 450000Henan ProvinceChina Department of Ophthalmology the First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450000Henan ProvinceChina

AIM:To analyze the impact of the coronavirus disease-2019(COVID-19)pandemic on the presentation and characteristics of patients hospitalized for ocular trauma in a tertiary hospital in China between 2019 and 2020.METHODS:A retrospective case study was designed to collect information on all cases of ocular trauma in a tertiary hospital from 2019 to 2020 and compare differences in inpatients’data(age,sex,admission vision acuity,type of diagnosis,hospital stays,mechanism of injury and location of injury).RESULTS:The total number of patients admitted to the Ophthalmology Department was 883(mean 73.58±11.25patients per month)in 2019 and 714(59.50±17.92patients per month)in 2020.The injury number of in work was also the most within the four types of location in this two year(42.36%in 2019,43.84%in 2020).The mean hospital stays were 12.66d in 2019 and 10.81d in 2020.The highest incidence of ocular trauma was the middleaged(41-65y)groups in 2019 and 2020.The most common cause of ocular trauma was sharp object in 2019(47.34%)and 2020(47.58%).The mechanical ocular trauma reaches98.98%in 2019 and 99.72%in 2020.CONCLUSION:The number of patients with ocular trauma decreased in 2020,but middle-aged(41-65y)are still high incident groups.Mechanical ocular trauma remains the leading cause of hospitalization for ocular trauma patients and the proportion of patients injured at home increases.It is necessary to arouse social attention and the public’s awareness of eye trauma protection should be strengthened during the pandemic.

关键词： COVID-19 eye emergency ocular trauma pandemic

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ocular trauma in a Rural Population of North China:The Handan Eye Study

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Biomedical and Environmental Sciences 2015年第7期28卷 495-501页

作者： ZHOU Jun WANG Feng Hua LU Hai LIANG Yuan Bo WANG Ning Li the Handan Eye Study Group Beijing Tongren Eye Center Capital Medical University Handan Eye Hospital School of Optometry and Ophthalmology Eye Hospital Wenzhou Medical University

Objective To determine the prevalence of ocular trauma and the proportion of blindness and visua impairment due to trauma in a rural population in northern China. Methods The Handan Eye Study is a population-based cross-sectional study that surveyed 6830 Chinese people aged 30＋ years from 13 randomly selected villages in Yongnian County, city of Handan, Hebei Province, in July, 2006. All participants underwent a standardized interview and extensive examinations. A structured questionnaire was used to collect information on ocular trauma. Results Of the 5837 participants who filled out the questionnaire, 124 subjects [2.1%; 95% confidence interval （CI）, 1.8%-2.5%] reported a history of ocular trauma in either eye, including 19 （0.3%） persons reporting trauma in both eyes. Men were more likely to have an eye injury than women [odds ratio （OR）, 3.3; 2.2-4.9]. In multiple logistic regression models, ocular trauma was significantly more frequent among normotensive participants when compared with hypertensive participants （hypertensive vs. normotensive＂ OR, 0.6; 0.4-0.9） and among participants who had a history of falls （OR, 2.4; 1.2-4.8）. The proportion of unilateral visual impairment and unilateral blindness due to trauma were 10.5% （13 subjects） and 21.0% （26 subjects）, respectively. Conclusion Our study reports the prevalence of severe ocular trauma among adults in rural China, revealing a high proportion of blindness and visual impairment due to trauma. These findings suggest the need for educational strategies to increase eye health awareness in this rural population with focus on providing at least appropriate first aid care to reduce blindness due to trauma.

关键词： ocular trauma Population-based survey Prevalence Risk factor Handan Eye Study

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ocular trauma treated with pars plana vitrectomy: early outcome report

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International Journal of Ophthalmology(English edition) 2016年第5期9卷 738-742页

作者： Mohammad Reza Mansouri Seyed Ali Tabatabaei Mohammad Soleimani Mohammad Yaser Kiarudi Saber Molaei Mehdi Rouzbahani Meysam Mireshghi Mohsen Zaeferani Mehrbod Ghasempour Department of ocular trauma and Emergency Eye Research centerFarabi Eye HospitalTehran University of Medical Sciences

AIM： To evaluate demographic variables and visual outcomes, among patients with ocular injuries involving the posterior segment, managed with pars plana vitrectomy.· METHODS： The records of patients were studied retrospectively from March to September 2010, to determine the age, gender, place of occurrence of trauma, visual acuity, anatomical site, nature of injury,wound length, the presence of an afferent pupillary defect, and the timing of vitrectomy. The ocular trauma Score was measured. The minimum follow-up from presentation was 6mo.·RESULTS： Ninety patients（77 males, 13 females）, with a mean age of 32.7 ±15.8y were included over the 6-month period. The majority of cases occurred in the workplace（47 patients）, followed by home（14 patients）.The mean visual acuity（log MAR） of patients significantly improved from 2.36 ±0.72 preoperatively to 1.50 ±1.14 postoperatively. Twenty-three patients had preoperative vision better than 2.0 log MAR, the postoperative visual acuity was significantly better among these patients than patients with worse than 2.0 log MAR（P 〈0.001）. Visual improvement between groups with early vitrectomy（〉7d）and delayed vitrectomy（〉7d） was not significantly different（P =0.66）. Postoperative visual acuity was not significantly different between patients with injury in Zone I and II（P =0.64）, but patients with injury in Zone III had significantly poorer visual acuity（P =0.02）. Patients with relative afferent pupillary defect had significantly poorer postoperative visual acuity（P =0.02）. Preoperative visual acuity, the difference of preoperative and postoperative visual acuity, and postoperative visualacuity were significantly different between groups with different ocular trauma scores（P〈 0.001）.·CONCLUSION： trauma is more likely to occur in men under 40 y of age and in the workplace. The favorable final visual outcome is associated with the absence of afferent pupillary defect, ocular trauma score and presenting visual acuity as well as the zone of injury, and not associated with the timing of

关键词： ocular trauma vitrectomy visual outcome timing

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ocular trauma in an urban Spanish population:epidemiology and visual outcome

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International Journal of Ophthalmology(English edition) 2021年第9期14卷 1327-1333页

作者： Marta Belmonte-Grau Guadalupe Garrido-Ceca Paula Marticorena-álvarez Department of Ophthalmology Hospital Universitario de La PrincesaMadrid 28006Spain Universidad Autónoma de Madrid Medicine UniversityMadrid 28006Spain

AIM:To describe epidemiological aspects,clinical findings,and visual results in eye trauma patients requiring urgent surgery at a tertiary hospital.METHODS:Retrospective review of adult patients requiring urgent surgery for trauma to the eyeball from January 2010 and April 2020.Data was collected relative to age,gender,mechanism of the injury,type of wound,initial and final visual acuity,number and type of surgeries carried out.Injuries were classed according to the Birmingham Eye trauma Terminology(BETT)and the ocular trauma Score(OTS)categories.RESULTS:The survey included 92 eyes.Mean age was 54.76±22.18 y.The most frequent cause was domestic accidents(44.6%),followed by aggression(22.80%)and occupational accidents(17.4%).trauma from aggression was more frequent in men(P=0.006)and accidents in the home more common in women(P=0.011).Patients over 65 y presented an odds ratio(OR)of 10.71 for suffering a domestic accident.Patients between 15-45 and 46-65 y were at higher risk of trauma from aggression(OR=17.52 and OR=10.94,respectively).As for the type of injury,63.04%were open-globe lesions,Zone II being the most frequently affected(27.2%).In Logistic regression analysis,old age(P=0.05)and retinal involvement(P=0.001)were found to be associated with higher rate of unfavourable visual outcome.CONCLUSION:The epidemiological aspects of eye trauma are highly dependent on the area of population studied.Domestic accidents are more relevant than workplace accidents in older urban areas with high socioeconomic status.A better knowledge of the epidemiological characteristics is useful for implementing specific prevention measures and appropriate treatment strategies.

关键词： ocular trauma epidemiology domestic accident

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Characteristics and visual outcomes of patients hospitalized for ocular trauma in central China: 2006-2011

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International Journal of Ophthalmology(English edition) 2015年第1期8卷 162-168页

作者： Ying Qi Feng-Yan Zhang Guang-Hua Peng Yu Zhu Guang-Ming Wan Wen-Zhan Wang Jing Ma Shi-Jie Ren Department of Ophthalmology the First Affiliated Hospital of Zhengzhou University

AIM: To complete the data of ocular trauma in central China, as a well-known tertiary referral center for ocular trauma, we documented the epidemiological characteristics and visual outcomes of patients hospitalized for ocular trauma in this region.METHODS: A retrospective study of patients hospitalized for ocular trauma in central China from 2006 to 2011 was performed.· RESULTS: This study included 5964 eyes of 5799 patients. The average age was 35.5 ±21.8y with a male-to-female ratio of 2.8:1. The most common age was 45-59 y age group. Most patients were farmers and workers(51.9%). The most common injuries were firework related(24.5%), road traffic related(24.2%), and work related(15.0%). Among the most common causative agents were firecrackers(24.5%), followed by metal/knife/scissors(21.4%). Most injuries occurred in January(14.2%),February(27.0%), and August(10.0%). There were 8.5%patients with ocular injuries combined with other injuries.The incidence of open ocular injuries(4585 eyes, 76.9%)was higher than closed ocular injuries(939 eyes, 15.7%).The incidences of chemical and thermal ocular injuries were 1.2% and 0.6%. ocular trauma score(OTS)predicted final visual acuity at non light perception(NLP), 20/200-20/50 and 20/40 with a sensitivity of 100%,and light perception(LP) /hand motion(HM) and 1/200-19/200 with a specificity of 100%.· CONCLUSION: This study provides recent epidemiological data of patients hospitalized for ocular trauma in central China. Some factors influencing the visual outcome include time interval between injury and visit to the clinic, wound location, open or closed globe injury, initial visual acuity, and OTS.

关键词： ocular trauma score ocular trauma visual acuity

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Visual outcomes in patients with open globe injuries compared to predicted outcomes using the ocular trauma Scoring system

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International Journal of Ophthalmology(English edition) 2015年第6期8卷 1229-1233页

作者： Nagib du Toit Hamza Mustak Colin Cook University of Cape Town/Groote Schuur Hospital

AIMTo determine the visual outcomes in adult patients who sustained open globe injuries and to determine whether the visual prognosis following an eye injury in an African setting differs from the predicted outcomes according to the ocular trauma Score (OTS) study. A secondary aim was to establish the evisceration rate for these injuries and assess how this form of intervention affected outcomes in comparison to the OTS.METHODSA prospective case series of all patients admitted with open globe injuries over a two-year (July 2009 to June 2011) period. Injuries were scored using the OTS and the surgical intervention was recorded. The best corrected visual acuity at three months was regarded as visual outcome.RESULTSThere were 249 open globe injuries, of which 169 patients (169 eyes) completed the 3-month follow-up. All patients underwent primary surgery, 175 (70.3%) repairs, 61 (24.5%) eviscerations and 13 (5.2%) other procedures. Globe eviscerations were mainly done on OTS Category 1 cases, but outcomes in this category were not found to be different from OTS outcomes. Outcomes were significantly worse in Category 2, but when the entire distribution was tested, the differences were not statistically significant. The overall association between OTS outcomes and the final visual outcomes in this study was found to be a strong (P<0.005).CONCLUSIONReliable information regarding the expected outcomes of eye injuries will influence management decisions and patient expectations. The OTS is a valuable tool, the use of which has been validated in many parts of the world-it may also be a valid predictor in an African setting.

关键词： ocular trauma open globe injuries ocular trauma Score evisceration and visual outcomes

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Establishment of a prediction tool for ocular trauma patients with machine learning algorithm

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International Journal of Ophthalmology(English edition) 2021年第12期14卷 1941-1949页

作者： Seungkwon Choi Jungyul Park Sungwho Park Iksoo Byon Hee-Young Choi Department of Ophthalmology Pusan National University HospitalBusan 49241Republic of Korea Biomedical Research Institute of Pusan National University Hospital Busan 49241Republic of Korea Department of Ophthalmology School of MedicinePusan National UniversityBusan 49241Republic of Korea

AIM:To predict final visual acuity and analyze significant factors influencing open globe injury prognosis.METHODS:Prediction models were built using a supervised classification algorithm from Microsoft Azure Machine Learning Studio.The best algorithm was selected to analyze the predicted final visual acuity.We retrospectively reviewed the data of 171 patients with open globe injury who visited the Pusan National University Hospital between January 2010 and July 2020.We then applied cross-validation,the permutation feature importance method,and the synthetic minority over-sampling technique to enhance tool performance.RESULTS:The two-class boosted decision tree model showed the best predictive performance.The accuracy,precision,recall,F1 score,and area under the receiver operating characteristic curve were 0.925,0.962,0.833,0.893,and 0.971,respectively.To increase the efficiency and efficacy of the prognostic tool,the top 14 features were finally selected using the permutation feature importance method:(listed in the order of importance)retinal detachment,location of laceration,initial visual acuity,iris damage,surgeon,past history,size of the scleral laceration,vitreous hemorrhage,trauma characteristics,age,corneal injury,primary diagnosis,wound location,and lid laceration.CONCLUSION:Here we devise a highly accurate model to predict the final visual acuity of patients with open globe injury.This tool is useful and easily accessible to doctors and patients,reducing the socioeconomic burden.With further multicenter verification using larger datasets and external validation,we expect this model to become useful worldwide.

关键词： machine learning ocular trauma open globe injury predictive model vision preservation

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Pediatric ocular trauma with pars plana vitrectomy in Southwest of China:clinical characteristics and outcomes

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International Journal of Ophthalmology(English edition) 2021年第9期14卷 1321-1326页

作者： Zuo-Xin Qin Yan He Yu-Fei Xu Tao Yu Yong Liu Nan Wu Southwest Hospital/Southwest Eye Hospital Third Military Medical University(Army Medical University)Chongqing 400038China Key Lab of Visual Damage and Regeneration&Restoration of Chongqing Chongqing 400038China

AIM:To investigate the clinical characteristics and predictive factors of pediatric ocular trauma patients with vitrectomy.METHODS:Pediatric ocular trauma patients(aged 14 y or younger)who received vitrectomy in Southwest Hospital between January 2007 and December 2017 were reviewed retrospectively.Age,gender,mechanism of injury,final visual acuity(VA),and prognostic factors were analyzed.RESULTS:A total of 139 eyes in 139 pediatric patients were included in the study.The mean age was 7.4±3.7 years old and the male-to-female ratio was 5:1.There were 104(74.8%)open globe injuries and 35(25.2%)closed globe injuries.The top one traumatic eye injuries were penetrating injuries occur through sharp metal objects(43.9%).After vitrectomy,116 patients had favorable anatomic outcome at the last follow-up,and 30 eyes(21.6%)achieved VA of 20/200 or better.Following univariate analysis,we found zone III injuries(P=0.021),poor initial VA(P=0.005),endophthalmitis(P=0.024),and recurrent retinal detachment(Pocular trauma.After Logistic regression analysis,the poor initial VA(odds ratio:8.276,95%CI:1.597-42.897,P=0.012)and recurrent retinal detachment(odds ratio:6.455,95%CI:2.372-17.562,Pocular trauma.CONCLUSION:The treatment of vitrectomy for severe ocular trauma results in favorable anatomic outcomes,but VA improvement is not as good as anatomic outcomes.Initial VA and recurrent retinal detachment are the independent prognostic indicators for unfavorable visual outcome of severe pediatric ocular trauma.

关键词： pediatric ocular trauma vitrectomy outcome

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