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Prediction of Substantial Closed-Globe Injuries in Orbital Wall Fractures Publisher Pubmed



Salari F1 ; Rafizadeh SM1 ; Fakhredin H1 ; Rajabi MT1 ; Yaseri M1 ; Hosseini F2 ; Fekrazad R3 ; Salari B4
Authors
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Authors Affiliations
  1. 1. Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, Tehran, Iran
  2. 2. Department of Health Information Technology and Management, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  3. 3. International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research, Network (USERN), Tehran, Iran
  4. 4. Orthodontics Department, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Shariati St, Tehran, Iran

Source: International Ophthalmology Published:2024


Abstract

Purpose: To determine risk factors for substantial closed-globe injuries in orbital fractures (SCGI) and to develop the best multivariate model for the prediction of SCGI. Methods: A retrospective study was performed on patients diagnosed with orbital fractures at Farabi Hospital between 2016 and 2022. Patients with a comprehensive ophthalmologic examination and orbital CT scan were included. Predictive signs or imaging findings for SCGI were identified by logistic regression (LR) analysis. Support vector machine (SVM), random forest regression (RFR), and extreme gradient boosting (XGBoost) were also trained using a fivefold cross-validation method. Results: A total of 415 eyes from 403 patients were included. Factors associated with an increased risk of SCGI were reduced uncorrected visual acuity (UCVA), increased difference between UCVA of the traumatic eye from the contralateral eye, older age, male sex, grade of periorbital soft tissue trauma, trauma in the occupational setting, conjunctival hemorrhage, extraocular movement restriction, number of fractured walls, presence of medial wall fracture, size of fracture, intraorbital emphysema and retrobulbar hemorrhage. The area under the curve of the receiver operating characteristic for LR, SVM, RFR, and XGBoost for the prediction of SCGI was 57.2%, 68.8%, 63.7%, and 73.1%, respectively. Conclusions: Clinical and radiographic findings could be utilized to efficiently predict SCGI. XGBoost outperforms the logistic regression model in the prediction of SCGI and could be incorporated into clinical practice. © The Author(s), under exclusive licence to Springer Nature B.V. 2024.