Korean J Ophthalmol.  2011 Aug;25(4):262-267. 10.3341/kjo.2011.25.4.262.

Evaluation of the Central Macula in Commotio Retinae Not Associated with Other Types of Traumatic Retinopathy

• Park JY
• Nam WH
• Kim SH
• Jang SY
• Ohn YH
• Park TK

• KMID: 1018415
• DOI: http://doi.org/10.3341/kjo.2011.25.4.262

Abstract

PURPOSE
To report on the anatomical and functional changes to the macula in nine patients suffering from commotio retinae not accompanied by any other types of traumatic retinopathy.
METHODS
Nine injured eyes with commotio retinae were evaluated soon after ocular trauma with ophthalmic examination, including Spectral-domain optical coherence tomography (SD-OCT). In 12 eyes of 6 patients, Humphrey visual field (HVF) and multifocal electroretinogram (mfERG) were performed. Re-examinations were periodically performed for a mean of 26 days. Data from 9 injured eyes were collected and compared to data collected from the 9 non-affected eyes of the same patients.
RESULTS
SD-OCT revealed no significant differences in the foveal thickness and total macular volume between traumatized and intact eyes in all 9 patients. Only 3 out of the 9 injured eyes showed abnormal findings in SD-OCT images such as discontinuity of the inner/outer segment (IS/OS) junction or abnormal hyper-reflectivity from the IS/OS and retinal pigment epithelium (RPE) lines in the macula. HVF and mfERG results did not show any functional deterioration in the injured eyes compared with intact eyes. During follow-up, the commotio retinae resolved in all 9 eyes. The changes to the outer retinal region detected in 3 patients by SD-OCT were also resolved.
CONCLUSIONS
Acute retinal changes in commotio retinae, not associated with other retinal pathologies, were resolved without histological and functional sequelae. In a few cases of commotio retinae, SD-OCT revealed transient abnormalities mainly observed at the IS/OS and RPE complexes.

Keyword

Commotio retinae; Humphrey visual field; Multifocal electroretinogram; Spectral domain optical coherence tomography

MeSH Terms

Adolescent
Adult
Child
Electroretinography
Eye Injuries/classification/*complications/pathology
Female
Follow-Up Studies
Humans
Macula Lutea/*injuries/pathology/physiopathology
Male
Middle Aged
Prognosis
Retinal Diseases/*etiology/pathology/physiopathology
Retinal Pigment Epithelium/injuries/pathology/physiopathology
Retrospective Studies
Tomography, Optical Coherence
Trauma Severity Indices
Visual Acuity
Visual Fields
Young Adult

Figure

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  Fig. 1 Case 2. (A) Fundus photograph showing retinal opacity on the day of trauma. (B) Fundus photograph at 7 days post-trauma showing resolution of commotio retinae. (C) and (D) are optical coherence tomography (OCT) images taken on the day of trauma, showing increased reflectivity in the area of the photoreceptor outer segment (these scans correspond to line scans a and b on A). (E) and (F) are OCT images taken 7 days post-trauma, revealing restoration to the normal alternated layer (these scans correspond to line scans c and d on B). Arrows denote the orientation of the OCT line scan.

• 

  Fig. 2 Case 6. (A) Fundus photograph and (C) optical coherence tomography, taken the day of trauma, revealing commotio retinae and anormal alternated layer. (B) and (D), taken 2 days post-trauma, showing resolution of the commotio retinae and unremarkable findings of the macula.

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  Fig. 3 Case 8. (A) Fundus photograph at 3 days post-trauma showed retinal opacity on the macula (arrow in the box denotes the orientation of the optical coherence tomography [OCT] line scan). (B) Fundus photograph at 54 days post-trauma revealing resolution of commotio retinae. (C) OCT scan at 3 days post-trauma showing the discontinuity of the inner segment/outer segment (IS/OS) junction at the corresponding area of the commotio retinae (arrow heads in C) (D) OCT scan at 54 days post-trauma demonstrate partial resolution of the discontinuity at the IS/OS junction (arrow heads in D). (E) At 88 days post-trauma, OCT revealed restoration of IS/OS junction.

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