Major ocular trauma in Taiwan: 2002–2004 versus 2012–2014

Abstract

We investigated the temporal changes in major eye injuries in Taiwan by reviewing the medical records of all patients with ocular trauma hospitalized at the National Cheng Kung University Hospital during 2002–2004 and 2012–2014. A total of 169 eyes (161 patients) during 2002–2004 and 121 eyes (120 patients) during 2012–2014 were enrolled (mean ± SD age: 41.9 ± 20.8 years in 2002–2004, and 51.8 ± 19.3 years in 2012–2014). Males accounted for ~75% of patients. The most frequent injury-causing object was metallic material (~24%), and blunt traumas were most frequently attributable to traffic accidents and falls. The most common locations of injuries for males and females were the workplace and home, respectively. Open-globe injuries occurred in ~70% of eyes, requiring primary repair, cataract extraction, and/or intraocular lens implantation. The frequencies of fall injury, lacrimal system laceration, lens injury, corneal/scleral foreign bodies, and use of intracameral antibiotics increased from 2002–2004 to 2012–2014, while those of closed-globe injury, vitreous haemorrhage, optic nerve injury, and medical treatment decreased. The final visual acuity remained poor (≤20/200) in >1/3 of injured eyes. Despite therapeutic advancements, major eye injuries still pose a high risk for poor visual outcome.

Ocular injuries among patients with major trauma in England and Wales from 2004 to 2021

“…Ocular injuries secondary to low falls in this setting increased significantly over the 18-year period from 7.2% to 25.2% and similar trends have been reported in other studies [1,[28][29][30][31]. These injuries are common among older adults however we did not see a clinically meaningful increase in age over the same period, contrary to what has been reported in other literature [28,31]. It may be that any rise in older adults sustaining these injuries in our data was offset by the increase in children suffering NAI.…”

“…A reduction in RTCrelated injuries may also account for the decline in patients with concomitant facial and pelvic injuries in our cohort as these are commonly associated with this injury mechanism [27]. Ocular injuries secondary to low falls in this setting increased significantly over the 18-year period from 7.2% to 25.2% and similar trends have been reported in other studies [1,[28][29][30][31]. These injuries are common among older adults however we did not see a clinically meaningful increase in age over the same period, contrary to what has been reported in other literature [28,31].…”

“…Firstly, the TARN registry has grown significantly in size over the study period owing to an increase in submitting hospitals since regional major trauma networks were established around 2012 and submission to TARN became mandatory for all trauma-receiving units, better case ascertainment secondary to Best Practice Tariffs, and improvements in major trauma identification owing to more prevalent imaging [14,15]. Changes in case ascertainment have been associated with an unmasking of "Silver Trauma" (major trauma in adults over 65) which may contribute to some of the trend data we report, although many of our findings are in keeping with other contemporary literature [1,26,28,31]. Secondly, patients in whom injuries are identified after discharge, or after the 30-day TARN data collection period are not included.…”

Trends in ocular injuries among major trauma patients in England and Wales from 2004 to 2021

“…RTCs, while historically the predominant mechanism, only accounted for 25.3% of cases in 2019/21 and this may account for the reduction in patients with concomitant facial and pelvic injuries in our cohort as these are commonly associated with RTCs 18 . Similar changes in demographics and injury mechanism have also been demonstrated in ocular injury not associated with major trauma in American and Taiwanese populations 19,20 . It has been suggested that older patients are at an increased risk of eye injury due to globe weakness second to previous ocular surgery 21 .…”

Nutritional Modulation of AMPK-Impact upon Metabolic-Inflammation

“…Interestingly the AMPK activator, AICAR impeded LPS- and FA-induced cytokine response, in part through NF-κB inhibition [ 16 ]. However, AICAR has its non-specific limitations, it can inhibit NF-κB DNA binding in human macrophages without AMPK activation [ 66 ].…”