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Outer retinal structure after closed-globe blunt ocular trauma. Retina 2014 Oct;34(10):2133-46

Date

04/23/2014

Pubmed ID

24752010

Pubmed Central ID

PMC4175068

DOI

10.1097/IAE.0000000000000169

Scopus ID

2-s2.0-84925287064 (requires institutional sign-in at Scopus site)   30 Citations

Abstract

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.

Author List

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

Authors

Joseph J. Carroll PhD Director, Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin
Thomas B. Connor MD Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin
Robert F. Cooper Ph.D Assistant Professor in the Biomedical Engineering department at Marquette University
Sang Hun Hong MD Assistant Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin
Ryan Walsh MD Associate Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin
William Wirostko MD Professor in the Ophthalmology and Visual Sciences department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Accidents, Traffic
Adolescent
Adult
Eye Injuries
Female
Humans
Male
Middle Aged
Ophthalmoscopy
Photoreceptor Cells, Vertebrate
Retina
Tomography, Optical Coherence
Vision Disorders
Visual Acuity
Wounds, Nonpenetrating
Young Adult