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M. Saleh, A. Sauer, T. Bourcier, C. Speeg, D. Gaucher; Optical Coherence Tomography Features of the Acute Traumatic Maculopathy (Berlin's Edema). Invest. Ophthalmol. Vis. Sci. 2010;51(13):6023.
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To report short term and mid-term outcomes in Acute Traumatic Maculopathy
Retrospective case series. Data of 15 eyes of 15 consecutive patients (14 men and 1 woman) with acute traumatic maculopathy were retrospectively reviewed. Eyes with macular haemorrhages and/or disruption of the Bruch's membrane were excluded. All patients had a comprehensive ophthalmic examination at presentation, one week, one month, and six months after the baseline visit. Examination included best corrected visual acuity, indirect ophthalmoscopy, intraocular pressure measurement, color fundus photography, and Optical Coherence Tomography. Multifocal Electroretinography, and computed visual field were also performed in 6 patients during the follow up.
The mean age of patients was 20.8 years and the mean follow up has reached 134.4 days. Mean visual acuity at the presentation was 20/70. Central Macular thickness (CMT) was normal in all eyes on OCT examination ( mean+- SD: 154.8+-24.3µ) as retinal macular profile. Nonetheless, all eyes have presented exaggerated reflectivity of the photoreceptor inner/outer segment junction (IS/OS) that could not be distinguished anymore from the adjacent retinal pigment epithelium. This aspect was not present on the fellow eye and had resolved spontaneously at the one week visit in all of the cases. At six months, six patients were assessed. Among them, visual acuity has restored completely in five eyes, and remained moderately impaired in one (mean final visual acuity=20/25). CMT was unchanged (Paired t test, p=0.42). Significant Multifocal ERG disturbances were found in these patients despite an excellent apparent clinical recovery.
Discoloration of the macula following closed globe injuries is highly correlated with a loss of distinction of the IS/OS junction from the RPE on OCT examination. The ERG disturbances noticed at the mid-term follow up could be related to a persisting defect of the outer retina.
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