Long-Term Outcomes of Acute Traumatic Maculopathy

Saleh, Maher; Letsch, J.; Bourcier, Tristan; Munsch, Christina; Speeg-Schatz, C.; Gaucher, David

doi:10.1097/iae.0b013e31820e8d78

Cited by 29 publications

(16 citation statements)

References 15 publications

(17 reference statements)

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“…Although the neurosensory detachment in our case was extensive, the anatomy of the inner retina and particularly the IS/OS junction was preserved, which is consistent with the rapid improvement of VA and mfERG activity. MfERG alterations have been previously studied in traumatic maculopathy cases6 and can persist up to 6 months 7. In the absence of a direct ocular force we hypothesise a rapid anteroposterior stress of the vitreous followed by rapid deceleration leading to retinal traction, capillary breaks, fluid extravasation and MO.…”

Section: Discussionmentioning

confidence: 86%

Unusual bilateral traumatic maculopathy following whiplash injury

Chronopoulos¹,

Lipski

Jonescu-Cuypers

et al. 2014

BMJ Case Reports

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An unusual extensive bilateral macular oedema (MO) with spontaneous resolution occurred following a car crash accident. Qualitative and quantitative analysis of the macular region using spectral domain optical coherence tomography (SD-OCT) and multifocal electroretinogram (mfERG) was performed daily during the first 7 days, as well as at 3 and 6 months following the accident. SD-OCT examination demonstrated extensive MO accompanied by neurosensory detachment and subretinal fluid. During the 7 days following the accident there was gradual resolution of the oedema accompanied by visual recovery. One year later no anatomical changes were observed, the mfERG showed complete recovery and visual acuity returned to normal level. Although whiplash is a common injury in motor vehicle accidents, whiplash maculopathy (WMP) is rarely reported, most likely due to underdiagnosis. Here we describe the spontaneous resolution of a severe MO after whiplash injury in a car crash accident

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Section: Discussionmentioning

confidence: 86%

Unusual bilateral traumatic maculopathy following whiplash injury

Chronopoulos¹,

Lipski

Jonescu-Cuypers

et al. 2014

BMJ Case Reports

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“…5,9,10,12 The appearance of this band has been reported to return to normal, 6,9,11 though others have reported variable recovery that is correlated to the region of the initial disruption. 5,10 These latter results are consistent with the original findings of Sipperley et al, who hypothesized that the resultant visual loss in commotio retinae may be determined by the amount of photoreceptor damage occurring during the initial trauma.…”

Section: Introductionmentioning

confidence: 99%

“…One of the more common changes reported on OCT is an increase in reflectivity/intensity of the hyperreflective band attributed to the inner segment/outer segment (IS/OS) junction, also referred to as the inner segment ellipsoid zone (ISe, or EZ), 5–11 however loss or attenuation of this band has also been reported. 5,9,10,12 The appearance of this band has been reported to return to normal, 6,9,11 though others have reported variable recovery that is correlated to the region of the initial disruption.…”

Section: Introductionmentioning

confidence: 99%

Outer Retinal Structure After Closed-Globe Blunt Ocular Trauma

Flatter

Cooper

Dubow

et al. 2014

Retina

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Purpose To evaluate outer retinal structural abnormalities in patients with visual deficits following closed globe blunt ocular trauma (cgBOT). Methods Nine subjects with visual complaints following cgBOT were examined between 1 month post-trauma and 6 years post-trauma. Spectral domain optical coherence tomography (SD-OCT) was used to assess outer retinal architecture, while adaptive optics scanning light ophthalmoscopy (AOSLO) was used to analyze photoreceptor mosaic integrity. Results Visual deficits ranged from central scotomas to decreased visual acuity. SD-OCT defects included focal foveal photoreceptor lesions, variable attenuation of the interdigitation zone, and mottling of the outer segment band, with one subject having normal outer retinal structure. AOSLO revealed disruption of the photoreceptor mosaic in all subjects, variably manifesting as foveal focal discontinuities, perifoveal hyporeflective cones, and paracentral regions of selective cone loss. Conclusions We observe persistent outer retinal disruption in subjects with visual complaints following cgBOT, albeit to a variable degree. AOSLO imaging allows assessment of photoreceptor structure at a level of detail not resolvable using SD-OCT or other current clinical imaging tools. Multimodal imaging appears useful for revealing the cause of visual complaints in patients following cgBOT. Future studies are needed to better understand how photoreceptor structure changes longitudinally in response to various trauma.

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“…In another retrospective case series, Saleh et al examined 20 patients with blunt eye trauma at presentation, 1 week, and 6 months with OCT. They reported that in all cases, initial OCT revealed an increase in reflectivity of the inner and outer segment junction, with an apposition of the latter to the retinal pigmented epithelium, which were back to normal after one week [21]. Pham reported thickening of the outer retinal structures and increased reflectivity in the outer photoreceptor segments as an OCT finding in their cases of acute traumatic maculopathy [22,23].…”

Section: Discussionmentioning

confidence: 98%

Severe blunt eye trauma causes a decrease in central macular thickness within first 48 hours of trauma

et al. 2015

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Background: Blunt eye trauma is an important emergency in ophthalmology practice, and may alter the structure of the macula. Objectives: To evaluate the optic coherence tomography (OCT) measurements of central macular thickness (CMT) among patients admitted to the hospital within 48 hours of blunt eye trauma. Methods: Prospective cross-sectional study to evaluate patients who were admitted to hospital with blunt eye trauma within 48 hours trauma. Spectral domain OCT was used to measure macular thickness. CMT measurements of 24 healthy and 26 traumatized eyes of same patients were analyzed as control and case groups, respectively. Results: The mean CMT measurements were 230.04 ± 18.64 μm in control and 226.50 ± 18.89 μm in traumatized groups. The difference between two groups was not statistically significant (P = 0.412). However, when the patients were classified according to the severity of trauma, CMT measurements of severely injured patients were found significantly lower than both healthy and mildly traumatized eyes (P = 0.008, P = 0.004, respectively). Conclusions: Early stage macular OCT findings at blunt eye trauma may change with the severity of trauma. We have determined an insignificant increase in the mildly traumatized group in CMT compared with the healthy group within the first 48 hours of blunt trauma as a sign of macular trauma. However, in the severely traumatized group in CMT values significantly decreased, which may be a sign of cellular loss. Further prospective studies with long follow-up periods are warranted to elucidate the effects of this decrease in thickness.

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Long-Term Outcomes of Acute Traumatic Maculopathy

Cited by 29 publications

References 15 publications

Unusual bilateral traumatic maculopathy following whiplash injury

Unusual bilateral traumatic maculopathy following whiplash injury

Outer Retinal Structure After Closed-Globe Blunt Ocular Trauma

Severe blunt eye trauma causes a decrease in central macular thickness within first 48 hours of trauma

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