External Long-Term Validation of the Retinal Detachment After Open Globe Injury (RD-OGI) Score in a Large Single-Center Cohort: A Retrospective Study with Up to Two Years of Follow-Up.

PURPOSE: To evaluate the long-term predictive potential of the Retinal Detachment after Open Globe Injury (RD-OGI) Score, designed to predict the risk of RD after penetrating ocular trauma. PATIENTS AND METHODS: Retrospective cohort study at a single tertiary-care academic hospital with a level 1 eye trauma center (Wilmer Eye Institute, Johns Hopkins University) including patients presenting with acute open globe injury (OGI) between 2006 and 2017. Visual acuity (VA), zone of injury (ZOI), and presence of vitreous hemorrhage (VH) at presentation were utilized to calculate the RD-OGI score. Incidence of RD following OGI up to 720 days was compared among low-, moderate-, and high-risk groups stratified by RD-OGI score. RESULTS: A total of 597 eyes with OGI were stratified into low (n=165, 27.6%), moderate (n=254, 42.5%) and high risk (n=178, 29.8%) groups per the RD-OGI scoring system. Individuals in the high-risk group were significantly older compared with those in moderate and low risk groups (47.4±24.2, 40.2±21.4 and 34.4±17.7, respectively) (p<0.001). The most common highest ZOI for low and moderate risk groups was zone I [64.2% (106 out of 165 total) of low-risk eyes and 51.2% (130 out of 254 total) of moderate risk eyes)]. Most eyes in the high risk group had a highest ZOI of either zone II (52.8%, 94 out of 178 total) or zone III (36.5%, 65 out of 178 total). Of the 306 eyes with follow-up information available 720 days after OGI, 150 (49.0%) had developed RD, with majority of these patients (83 out of 150, 55.3%) belonging to the high risk group. The RD-OGI score exhibited its strongest predictive performance at 6 months, with an area under the curve (AUC) of 0.774 (95% confidence interval [CI]: 0.730-0.819), and demonstrated a slight decline in predictive performance by 720 days post-injury (AUC: 0.739, 95% CI: 0.684-0.794). CONCLUSION: RD-OGI score provides a reliable method to stratify risk of developing RD after penetrating ocular trauma, with moderate predictive performance at 6 months (AUC: 0.774, 95% CI: 0.730-0.819), that was maintained over longer term follow up at 2 years (AUC: 0.739, 95% CI: 0.684-0.794).