Abstract
Purpose :
We aim to describe the rate and clinical characteristics of rhegmatogenous retinal detachments occurring following commotio retinae in the setting of ocular trauma.
Methods :
A single center, retrospective chart review of all patients who presented with commotio retinae between January 2015, and June 2022. Those who had a ruptured globe, prior retinal detachment (RD) or who concomitantly presented with a RD, and those with history of vitreoretinal surgery were excluded.
Results :
380 eyes of 380 patients were diagnosed with commotio retinae after blunt trauma and met inclusion criteria. 262 (68.9%) were male and mean (SD) age was 31.78 (18.98) years, [range 4 to 82 years]. Mean (SD) follow up duration was 409 (590) days.
During follow-up, 15 (3.95%) patients developed a RD post-commotio. RD developed 36±68 days post-commotio [range 1 to 237 days]. Mean (SD) log MAR visual acuity (VA) [Snellen] at initial presentation to the emergency room was worse in eyes that subsequently developed RD 0.93 (0.84) [20/170] compared to eyes that did not develop RD 0.44 (0.64) [20/55] (p= 0.013).
PVD and VH were found in 2 (13.3%) and 9 (60%) eyes who developed RD respectively, compared to 74 (20.3%) and 110 (30.2%) of non-RD eyes (p= 0.443 and p= 0.028) respectively. 15 (100%) were macula-sparing, 9 (60%) were from retinal dialyses, and the average number of retinal breaks was 1.75, and average extent of RD was 2.78 clock hours.
Ten (66.7%) were focal and treated with demarcation laser photocoagulation and needed no further treatment. Two (13.3%) underwent vitrectomy with silicone oil tamponade: One patient’s retina remained attached under oil, while the second had a shallow RD under oil. One patient had a subclinical RD and was closely observed. One (6.7%) was lost to follow-up and another (6.7%) sought care elsewhere.
Conclusions :
Most cases of commotio retinae are self-limited and do not result in long-term complications. However, 4% of patients in our cohort developed subsequent retinal detachment. Patients should be followed closely and counseled accordingly.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.