Outer retinal structure after closed-globe blunt ocular trauma

John A. Flatter; Robert F. Cooper; Michael J. Dubow; Alexander Pinhas; Ravi S. Singh; Rashmi Kapur; Nishit Shah; Ryan D. Walsh; Sang H. Hong; David V. Weinberg; Kimberly E. Stepien; William J. Wirostko; Scott Robison; Alfredo Dubra; Richard B. Rosen; Thomas B. Connor; Joseph Carroll

doi:10.1097/IAE.0000000000000169

Outer retinal structure after closed-globe blunt ocular trauma

John A. Flatter, Robert F. Cooper, Michael J. Dubow, Alexander Pinhas, Ravi S. Singh, Rashmi Kapur, Nishit Shah, Ryan D. Walsh, Sang H. Hong, David V. Weinberg, Kimberly E. Stepien, William J. Wirostko, Scott Robison, Alfredo Dubra, Richard B. Rosen, Thomas B. Connor, Joseph Carroll

Icahn School of Medicine at Mount Sinai

Research output: Contribution to journal › Article › peer-review

31 Scopus 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.

Original language	English
Pages (from-to)	2133-2146
Number of pages	14
Journal	Retina
Volume	34
Issue number	10
DOIs	https://doi.org/10.1097/IAE.0000000000000169
State	Published - 12 Oct 2014

Keywords

acute macular neuroretinopathy
adaptive optics
commotio retinae
cones
en face spectral domain optical coherence tomography
ocular trauma
outer retinal architecture
photoreceptors
retinal imaging

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Flatter, J. A., Cooper, R. F., Dubow, M. J., Pinhas, A., Singh, R. S., Kapur, R., Shah, N., Walsh, R. D., Hong, S. H., Weinberg, D. V., Stepien, K. E., Wirostko, W. J., Robison, S., Dubra, A., Rosen, R. B., Connor, T. B., & Carroll, J. (2014). Outer retinal structure after closed-globe blunt ocular trauma. Retina, 34(10), 2133-2146. https://doi.org/10.1097/IAE.0000000000000169

@article{0d8f85fe9b7046e09882b6a2ecb3bf2a,

title = "Outer retinal structure after closed-globe blunt ocular trauma",

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.",

keywords = "acute macular neuroretinopathy, adaptive optics, commotio retinae, cones, en face spectral domain optical coherence tomography, ocular trauma, outer retinal architecture, photoreceptors, retinal imaging",

author = "Flatter, {John A.} and Cooper, {Robert F.} and Dubow, {Michael J.} and Alexander Pinhas and Singh, {Ravi S.} and Rashmi Kapur and Nishit Shah and Walsh, {Ryan D.} and Hong, {Sang H.} and Weinberg, {David V.} and Stepien, {Kimberly E.} and Wirostko, {William J.} and Scott Robison and Alfredo Dubra and Rosen, {Richard B.} and Connor, {Thomas B.} and Joseph Carroll",

note = "Publisher Copyright: Copyright {\textcopyright} by Ophthalmic Communications Society, Inc.",

year = "2014",

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doi = "10.1097/IAE.0000000000000169",

language = "English",

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T1 - Outer retinal structure after closed-globe blunt ocular trauma

AU - Flatter, John A.

AU - Cooper, Robert F.

AU - Dubow, Michael J.

AU - Pinhas, Alexander

AU - Singh, Ravi S.

AU - Kapur, Rashmi

AU - Shah, Nishit

AU - Walsh, Ryan D.

AU - Hong, Sang H.

AU - Weinberg, David V.

AU - Stepien, Kimberly E.

AU - Wirostko, William J.

AU - Robison, Scott

AU - Dubra, Alfredo

AU - Rosen, Richard B.

AU - Connor, Thomas B.

AU - Carroll, Joseph

PY - 2014/10/12

Y1 - 2014/10/12

N2 - 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.

AB - 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.

KW - acute macular neuroretinopathy

KW - adaptive optics

KW - commotio retinae

KW - cones

KW - en face spectral domain optical coherence tomography

KW - ocular trauma

KW - outer retinal architecture

KW - photoreceptors

KW - retinal imaging

UR - http://www.scopus.com/inward/record.url?scp=84925287064&partnerID=8YFLogxK

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DO - 10.1097/IAE.0000000000000169

M3 - Article

C2 - 24752010

AN - SCOPUS:84925287064

SN - 0275-004X

VL - 34

SP - 2133

EP - 2146

JO - Retina

JF - Retina

IS - 10

ER -

Outer retinal structure after closed-globe blunt ocular trauma

Abstract

Keywords

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