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S. E. Ludlow, K. S. Bower, D. W. Chun; Retinal Atrophy Evaluated by Optical Coherence Tomography in Patients With Blunt Combat Ocular Trauma. Invest. Ophthalmol. Vis. Sci. 2010;51(13):6028.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the optical coherence tomography (OCT) findings in macular retinal atrophy secondary to combat-related blunt ocular trauma in soldiers injured during Operations Iraqi and Enduring Freedom.
Retrospective noncomparative case series of six United States military personnel with unilateral closed globe ocular trauma evaluated with either Stratus or Cirrus OCT (Carl Zeiss Meditec, Inc., Dublin, CA) macular scans. The retinal thickness of the central and surrounding four inner and outer quadrant subfields were compared between the injured and non-injured eyes in each patient. Retinal atrophy was classified as inner, outer, or full thickness. Location of OCT findings were then compared to location of retinal pigment epithelium (RPE) changes documented on exam notes, fluorescein angiography (FA), or fundus photos. Soldiers with traumatic macular holes, macular choroidal rupture or macular sclopetaria were excluded.
The difference of retinal thickness between unaffected corresponding subfields in all patients was less than 5%, establishing a baseline. Five patients (83%) had greater than 10% atrophy in at least one subfield in the injured eye. Three patients (50%) had greater than 15% atrophy. One patient had diffuse thinning of 3.4% to 14% in all nine subfields. The most common subfields to be affected were central, inner-superior, and inner-nasal quadrants. Outer retinal segment atrophy was seen in four patients on OCT. Two patients had full thickness loss. Isolated inner segment loss was not observed. The location of RPE changes noted on clinical notes, FAs, and fundus photos correlated well with the location of retinal atrophy established by OCT.
Blunt ocular trauma in the setting of combat can result in macular retinal atrophy primarily affecting the outer retinal segment. OCT is a useful diagnostic tool in evaluating macular retinal atrophy particularly when there are RPE changes on fundus exam.
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