Afshin Parsikia

Corrigendum to ‘Visual Pathway Injuries in Pediatric Ocular Trauma – A Survey of the National Trauma Data Bank from 2008-2014’ [Pediatric Neurology 85 (2018) 43-50]

Corrigendum to ‘Visual Pathway Injuries in Pediatric Ocular Trauma A Survey of the National Trauma Data Bank from 2008-2014’ [Pediatric Neurology 85 (2018) 43-50] Ryan Gise , Timothy Truong, Afshin Parsikia , Joyce N. Mbekeani a,d a Department of Ophthalmology & Visual Sciences, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York b Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York c Department of Surgery (Trauma), Jacobi Medical Center, Bronx, New York d Department of Surgery (Ophthalmology), Jacobi Medical Center, Bronx, New York

Visual Pathway Injuries in Pediatric Ocular Trauma—A Survey of the National Trauma Data Bank From 2008 to 2014

BACKGROUNDnTraumatic visual pathway injuries are often associated with severe head trauma and can have profound deleterious effects in developing children and their rehabilitation. We sought to elucidate the epidemiology of pediatric visual pathway injuries in the United States.nnnMATERIALS AND METHODSnThis study is a retrospective evaluation of pediatric patients (less than 21 years of age) with visual pathway injuries that were submitted to the National Trauma Data Bank between 2008 to 2014. Patients were identified using the International Classification of Diseases, Ninth Revision Clinical Modification codes. Statistical analysis was performed with SPSS software. Variables were correlated using Student t test, chi-squared test, and logistic regression analyses.nnnRESULTSnOf the 58,765 pediatric patients (1.7%) who were admitted with ocular injuries, 970 had visual pathway injuries. The majority of these patients were male (69.2%), and the mean age was 11.6 years (±7.2). Traumatic optic neuropathy was the most common (86.1%) visual pathway injury. It had the greatest odds of occurring with oculomotor nerve injury (odds ratioxa0=xa03.84; Pxa0<xa00.001). Associated ocular injuries were open adnexal wounds (87.4%) and orbital fractures (23%). Common mechanisms were motor vehicle occupant (21.5%) and firearms (15.6%). Motor vehicle occupants were most likely white and firearms injury, black. In the zero to three years age group, most injuries were due to falls; injuries in the 19 to 21 years age group had the greatest association with firearms. Overall mortality was 17.6%.nnnCONCLUSIONSnVisual pathway injuries may have devastatating sequelae and should be considered in pediatric ocular injuries. The clear majority were traumatic optic neuropathies. The common mechanisms, motor vehicle occupant and firearms, revealed age and race disparities.

Pediatric traumatic brain injury and ocular injury

PURPOSEnTraumatic brain injury (TBI) is a leading cause of pediatric disability and mortality. Together with sight-threatening ocular injuries, TBIs may lead to devastating consequences in developing children and complicate rehabilitation. We sought to investigate this relationship in pediatric patients admitted with major trauma.nnnMETHODSnThe records of pediatric patients admitted with ocular injury and concomitant TBI were reviewed retrospectively using the National Trauma Data Bank (2008-2014).nnnRESULTSnOf 58,765 pediatric patients admitted for trauma and also had ocular injuries, 32,173 were diagnosed with TBI. Mean patient age was 12.3xa0±xa07xa0years. Most were male (69.8%) and White (61.2%). The most frequent injuries were contusion of the eye/adnexa (39.1%) and orbital fractures (35.8%). The youngest age groups had greatest odds of falls in home locations, whereas older groups were more likely to suffer motor vehicle trauma as occupants (MVTO), struck by or against (SBA) injuries, and firearms injuries in street locations (Pxa0<xa00.001). Blacks and Hispanics were most likely to suffer assault (Pxa0<xa00.001) and Whites, unintentional (Pxa0<xa00.001) and self-inflicted (Pxa0<xa00.012) injury. Blacks were at a higher risk of firearms injury, Whites of MVTO, and Hispanics of motor vehicles as pedestrians (Pxa0<xa00.001).nnnCONCLUSIONSnTBI frequently is experienced by trauma patients with concomitant ocular injury and should be considered in children admitted with major trauma. Resultant demographic patterns may help identify patients that have a higher risk of TBI leading to earlier diagnosis and treatment.