Multimodal imaging of soccer ball-related ocular posterior segment injuries

Abstract

Purpose To investigate the clinical and anatomic characteristics of soccer ball-induced posterior segment injuries in the era of modern multi-modal imaging. Methods Retrospective case series of patients with soccer ball injury and diagnostic imaging from 2007 to 2020 at a single vitreoretinal practice. Results Eight patients met inclusion criteria. Fundus photographs (FP) and optical coherence tomography (OCT) were obtained in eight patients, fundus autofluorescence (FAF) in five patients, fluorescein angiography (FA) in three patients, and en-face OCT and OCT-Angiography (OCT-A) were obtained in two patients each. FA and FAF identified traumatic pigment epitheliopathy secondary to commotio. Increased hypo-autofluorescence was associated with shallow, peripheral retinal detachment on FAF. OCT of the macula displayed outer retinal changes associated with commotio, and offered insight into the acute and subacute changes of traumatic macular hole formation. A patient displayed foveal hyper-reflectivity in the shape of an hourglass with retinal cyst at the level of the external limiting membrane (ELM) as seen on OCT and En-face OCT. A patient with commotio involving the macula lacked microvascular changes on OCT-A. Conclusion OCT, FA, and FAF imaging may aid in the work-up and management of the soccer ball-related posterior segment injuries.

Discrepancy of eye injuries in mechanism, clinical features, and vision prognosis by different causative sports

“…The soccer ball, relatively slow and soft compared to other balls, can deform and mold on impacting the contour of the orbital aperture ( 32 ), and remains in contact with the orbit for approximately 10 ms, 2.5 to 10 times longer than other balls ( 8 ). The impact can generate transient pockets of high and negative pressure (a suction effect as it withdraws) with a peak of 66.6 kPa near the impact point, and the impact subsequently propagates linear pressure wave, exerting compressive and tractional forces on the retina, especially localized to the posterior pole or superior temporal quadrant ( 8 , 33 ).…”