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Kimberly E. Stepien, Wanda M. Martinez, Adam M. Dubis, Robert F. Cooper, Alfredo Dubra, Joseph Carroll; Detection of Photoreceptor Disruption after Commotio Retinae using Adaptive Optics Scanning Laser Ophthalmoscopy. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6657.
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© ARVO (1962-2015); The Authors (2016-present)
To present adaptive optics scanning laser ophthalmoscopy (AOSLO) images of photoreceptor disruption as a result of commotio retinae.
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.
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.
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.
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