Spectral-Domain Optical Coherence Tomography in Patients With Commotio Retinae

Abstract

Spectral-domain optical coherence tomography of mild lesions with good visual outcome showed transient hyperreflectivity of the outer retina. The cases with severe trauma were related to acute disruption of the inner/outer segment junction and hyperreflectivity of the overlying retina and were regularly associated with retinal atrophy, pigment disturbance, and poor visual prognosis.

Outer Retinal Structure After Closed-Globe Blunt Ocular Trauma

“…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.…”

Spectral Domain-Optical Coherence Tomography Findings of Commotio Retinae With Associated Serous Retinal Detachment

“…[5][6][7] In some cases, however, it has been shown to progress to retinal thinning in the affected areas 4 with outer retinal atrophy and pigment disruption leading to more extensive visual loss. 7 Other findings associated with commotio retinae and blunt ocular trauma can also limit visual potential. There have been few reports of associated full-thickness macular hole.…”

Chorioretinitis sclopetaria

“…It is known that the choroid ruptures are associated with blunt trauma, either by direct or indirect mechanism (19,(28)(29)(30)(31)(32) . Retinal and macula whitening with a cherry aspect (Berlin edema) have also been reported after eye injuries, a condition that is known as commotio retinae (21)(22)(23)(24)(25)(26)(27) . Both can appear in chorioretinitis sclopetaria, as it also has a blunt component in its pathophysiology.…”

“…In cases of multiple lesions, they are often parallel with the largest one being central and the smallest one peripheral. A compression mechanism (Commotio retinae) may also be involved, leading to Berlin edema (21)(22)(23)(24)(25)(26)(27) . Changes in motility, either by restriction or by direct injury of the extraocular muscles, may be present.…”