AOphthalmology, BDepartment of Cell Biology, Neurobiology and Anatomy, 1Medical College of Wisconsin, Milwaukee, Wisconsin
2Department of Biomedical Engineering, Marquette University, Milwaukee, Wisconsin
3Flaum Eye Institute, University of Rochester, Rochester, New York
Commercial Relationships: Kimberly E. Stepien, None; Wanda M. Martinez, None; Adam M. Dubis, None; Robert F. Cooper, None; Alfredo Dubra, None; Joseph Carroll, None
Support: CTSI-MCW,CTSA Grant UL1 RR 031973, E. Matilda Ziegler Foundation for the Blind, RD and Linda Peters Foundation, Research to Prevent Blindness, and NIH (EY017607, EY001931, EY014537).
Purpose:To present adaptive optics scanning laser ophthalmoscopy (AOSLO) images of photoreceptor disruption as a result of commotio retinae.
Methods:A 41 year-old male with a 4 year history of a stable, well defined, crescent-shaped scotoma after an industrial accident in which he experienced significant head trauma underwent complete ophthalmic exam, fluorescein angiogram (FA), spectral domain optical coherence tomography (SD-OCT), Humphrey visual field (HVF) testing, and microperimetry. Newly developed (Jan 2011) confocal AOSLO imaging was also performed.
Results:Clinical exam, FA, SD-OCT and 24-2 HVF testing detected no abnormalities. Central non-specific changes were seen on 10-2 HVF. AOSLO imaging revealed a crescent-shaped area of cone photoreceptor mosaic disruption just temporal to the fovea (Figure 1. Fovea - white rectangle; Photoreceptor disruption - darker area temporal to fovea) indicating a compromise in photoreceptor structural integrity within this area. Microperimetry confirmed corresponding functional visual loss in this region.
Conclusions:AOSLO imaging revealed a well-defined area of photoreceptor mosaic disruption from prior commotio retinae injury not detected by clinical exam or other imaging. AOSLO may be useful in the detection and better understanding photoreceptor pathology in the setting of eye trauma or severe head/body trauma, including traumatic brain injury.
Keywords: trauma retina imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound)
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