Outer retinal structure after closed-globe blunt ocular trauma.

Alfredo Dubra // Kimberly Stepien // Publications // Oct 01 2014

PubMed ID: 24752010

Author(s): Flatter JA, Cooper RF, Dubow MJ, Pinhas A, Singh RS, Kapur R, Shah N, Walsh RD, Hong SH, Weinberg DV, Stepien KE, Wirostko WJ, Robison S, Dubra A, Rosen RB, Connor TB Jr, Carroll J. Outer retinal structure after closed-globe blunt ocular trauma. Retina. 2014 Oct;34(10):2133-46. doi: 10.1097/IAE.0000000000000169. PMID 24752010

Journal: Retina (Philadelphia, Pa.), Volume 34, Issue 10, Oct 2014

PURPOSE To evaluate outer retinal structural abnormalities in patients with visual deficits after closed-globe blunt ocular trauma.

METHODS Nine subjects with visual complaints after closed-globe blunt ocular trauma were examined between 1 month after trauma and 6 years after trauma. Spectral domain optical coherence tomography was used to assess the outer retinal architecture, whereas adaptive optics scanning light ophthalmoscopy was used to analyze the photoreceptor mosaic integrity.

RESULTS Visual deficits ranged from central scotomas to decreased visual acuity. Spectral domain optical coherence tomography 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. Adaptive optics scanning light ophthalmoscopy 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.

CONCLUSION We observe persistent outer retinal disruption in subjects with visual complaints after closed-globe blunt ocular trauma, albeit to a variable degree. Adaptive optics scanning light ophthalmoscopy imaging allows the assessment of photoreceptor structure at a level of detail not resolvable using spectral domain optical coherence tomography or other current clinical imaging tools. Multimodal imaging seems to be useful in revealing the cause of visual complaints in patients after closed-globe blunt ocular trauma. Future studies are needed to better understand how photoreceptor structure changes longitudinally in response to various traumas.