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Abstract

Purpose: Evaluate visual evoked potential (VEP) and ocular trauma score efficacy in predicting visual potential in globe trauma without optic nerve involvement.

Methods: A retrospective cohort study analyzed clinical data from eye globe injury cases undergoing flash VEP between January 2000 and May 2021. Inclusion criteria: flash VEP completion within 48 hours and presurgical intervention. Exclusion criteria: head trauma and optic nerve injuries. Abnormal VEP: amplitudes <7 µ V and latencies >120 milliseconds. The ocular trauma score was computed, and penetrating injuries were categorized.

Results: Of 85 eyes meeting the criteria (mean age: 31.9 ± 20.6 years, 82.4% male), the median follow-up was 22 months. Ocular trauma score directly correlated with the amount of Early Treatment Diabetic Retinopathy Study letters gained at follow-up and was inversely correlated with ocular penetration extent and VEP signal amplitude. Visual evoked potential amplitude is inversely correlated with maintaining/improving visual acuity. Positive predictive value for normal VEP predicting maintained/improved visual acuity: 75.6%, negative predictive value: 21.3%. In blunt trauma, baseline VEP amplitude had superior predictive value compared with penetrating injury.

Conclusion: This study highlights a correlation between VEP signal amplitude and ocular trauma score with visual outcomes in traumatic eye injuries without optic nerve involvement. Ocular trauma score emerges as a reliable VEP substitute, particularly in blunt trauma cases, where baseline VEP amplitude predicts visual recovery more accurately than penetrating injuries.