目的：探讨眼外伤评分(OTS)、初诊视力与眼球结构参数在眼外伤愈后视力评估中的价值。

方法：选取司法鉴定科学研究院2015-06/2021-06受理并出具明确鉴定意见的眼外伤者302例302眼，根据眼外伤愈后最佳矫正视力(BCVA)进行分组，Ⅰ组63例63眼，BCVA<3.7； Ⅱ组70例70眼3.7≤BCVA<4.5； Ⅲ组78例78眼，4.5≤BCVA<4.9； Ⅳ组91例91眼，BCVA≥4.9。另选取纳入的眼外伤者健眼77例77眼作为对照组即Ⅴ组。分析纳入研究对象的眼外伤愈后BCVA和眼球结构参数及其相关性，并使用IBM SPSS Modeler 18.0软件建立预测眼外伤愈后视力的随机森林(RF)和支持向量机(SVM)模型。

结果：纳入眼外伤者初诊视力、OTS评分、眼外伤愈后角膜分级、晶状体分级、眼底分级、视神经周围神经纤维层厚度与眼外伤愈后BCVA均存在相关性(P<0.01)。除中央视网膜厚度外，各组眼球结构参数均有差异(P<0.001)。SVM模型较RF模型预测眼外伤愈后视力的准确率高，误差在0.15以内者准确率达80%以上。

结论：OTS评分与眼球结构检查可为眼外伤后视觉功能障碍的法医临床鉴定提供有效信息，在鉴别伪装视觉功能障碍中具有价值。

METHOD: A total of 302 cases(302 eyes)of ocular trauma were selected as subjects, which were accepted and issued clear appraisal opinions by the Academy of Forensic Science from June 2015 to June 2021. The subjects were grouped according to the healing best corrected visual acuity(BCVA)from ocular trauma. Group Ⅰ included 63 cases(63 eyes)with BCVA <3.7; Group Ⅱ included 70 cases(70 eyes)with 3.7≤ BCVA <4.5; Group Ⅲ included 78 cases(78 eyes)with 4.5≤ BCVA <4.9; Group Ⅳ included 91 cases(91 eyes)with BCVA≥4.9. In addition, 77 cases(77 healthy eyes)of ocular trauma were selected as the control group, namely Group Ⅴ. The healing BCVA and ocular structural parameters from ocular trauma and theirs correlation were analyzed, and the random forest(RF)and support vector machine(SVM)model of healing visual acuity was established by the IBM SPSS Modeler 18.0.

RESULTS: The initial visual acuity, OTS, the grading of corneas, lenses, and fundus, and the thickness of the retinal never fiber layer of ocular trauma patients were correlated with the healing BCVA(P<0.01). There were significant differences in ocular structural parameters among groups, except the central subfield thickness(P<0.001). The SVM model had higher accuracy of predicting healing visual acuity than the RF model, and the accuracy rate was over 80% when the error was within 0.15.

CONCLUSION:OTS and ocular structural examination can provide effective information for the clinical forensic medicine appraisal of visual dysfunction after ocular trauma, and they are valuable in discriminating camouflage of visual dysfunction.