J Korean Ophthalmol Soc.  2008 Sep;49(9):1539-1542.

A Case of Retinal Contusion Combined Exudative Retinal Detachment Causing Delayed Visual Disturbance

Affiliations
  • 1Department of Ophthalmology, Pusan National University School of Medicine, Pusan, Korea. bsoum@pusan.ac.kr

Abstract

PURPOSE
To report a case of retinal contusion with the complication of exudative retinal detachment causing delayed visual disturbance.
CASE SUMMARY
A 28-year-old man presented with visual disturbance of the left eye. Three days prior, a soccer ball hit him on his left eye, and he visited a local clinic. His visual acuity was 0.9. Fundus examination revealed a lesion of the macula, which was diagnosedas retinal contusion. Two days later, visual acuity decreased to 0.3 and he was referred to us. At presentation, his visual acuity was 0.125. A gray to white lesion around the superotemporal vascular arcade, and exudative retinal detachment involving the fovea associated with the lesion were found. Subretinal fluid collection was confirmed with optical coherence tomography (OCT). Fluorescein angiography showed diffuse leakage over the contusion, and fluorescein was pooled in the detached area. At 15 days, subretinal fluid was resolved on OCT and vision was improved to 0.8.
CONCLUSIONS
We suggest that leakage from the contusion caused delayed exudative retinal detachment and decrease of visual acuity. Visual acuity improved with resolution of the subretinal fluid. Though the visual acuity was good in spite of a severe retinal contusion on the perifoveal area, the possibility of exudative retinal detachment and delayed visual disturbance shoud be considered.

Keyword

Exudative retinal detachment; Retinal contusion

MeSH Terms

Adult
Contusions
Eye
Fluorescein
Fluorescein Angiography
Humans
Retinal Detachment
Retinaldehyde
Soccer
Subretinal Fluid
Tomography, Optical Coherence
Vision, Ocular
Visual Acuity
Fluorescein
Retinaldehyde

Figure

  • Figure 1. (A) Color photograph shows retinal contusion complicated with exudative retinal detachment (arrow) involving the fovea at 3 days after blunt ocular trauma. (B) Fluorescein angiograph reveals multiple leakage around the superotemporal vascular arcade in the early phase. (C) In the late phase, leakage became diffuse over the contusion area. Fluorescein is pooled in detached area (arrows).

  • Figure 2. (A) Optical coherence tomographd emonstrates subretinal fluid associated with retinal contusion 3 days after blunt trauma. (B) At 15 days, subretinal fluid is resolved on OCT. Vision improved to 0.8. (C) Color photograph at 15 days. Exudative retinal detachment disappeared and retinal contusion remained.


Reference

References

1. Berlin R. Zur sogennanten commotion retinae. Klin Monatsbl Augenheilkd. 1873; 1:42–78.
2. Mansour AM, Green WR, Hogge C. Histopathology of commotion retinae. Retina. 1992; 12:24–8.
3. Williams DF, Mieler WF, Williams GA. Posterior segment manifestations of ocular trauma. Retina. 1990; 10:35–44.
Article
4. Hart JC, Frank HJ. Retinal opacification after blunt non perforating concussional injuries to the globe. A clinical and retinal fluorescein angiographic study. Trans Ophthalmol Soc U K. 1975; 95:94–100.
5. Balantype AJ, Michaelson IC. Test Book of The Fundus of The Eye. 1st. Baltimore: The Williams and wilkins Co;1963. p. 318.
6. Adler FH. Text Book of Ophthalmology. 7 TH ed. Philadelphia. London: WB Saunders Co;1962. p. 352.
7. Duke-Elder S. Parsons’ Disease of The Eye, 12 TH ed. New York: The Macmillan Co.;1954. p. 368.
8. Allen JH. May’s Disease of The Eye. 23 TH ed. Baltimore: Williams and Wilkins Co.;1968. p. 211.
9. Conrad Berens. The Ryr and Its Disease, Philadelphia. London: W.B Saunders Co.;1950. p. 610.
10. Blight R, Hart JC. Structural changes in the outer retinal layers following blunt mechanical non-perforating trauma to the globe: an experimental study. Br J Ophthalmol. 1977; 30:573–87.
Article
11. Slipperley JO, Quigley HA, Gass DM. Traumatic retinopathy in primares. The explanation of commtio retinae. Arch Ophthalmol. 1978; 96:2267–73.
12. Mansour AM, Green WR, Hogge C. Histopathology of commotio retinae. Retina. 1992; 12:24–8.
Article
13. Pulido JS, Blair NP. The blood-retinal barrier in Berlin’s edema. Retina. 1987; 7:233–6.
Article
14. Meyer CH, Rodrigues EB, Mennel S. Acute commotion retinae determined by cross-sectional optical coherence tomography. Eur J Ophthalmol. 2003; 13:816–8.
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