Investigation Of Traumatic Retinopathy With Spectral Domain Optical Coherence Tomography

PURPOSE: To investigate the changes of microstructure in traumatic retinopathy using spectral domain optical coherence tomography (OCT).METHODS: This is a retrospective study was conducted. The patients of Joint Shantou International Eye Center (JSIEC) suffered from traumatic retinopathy were included in this study. The JSIEC outpatient database and spectral domain OCT database was searched and reviewed. The OCT imaged was analysed.RESULTS: Totally 138 eyes of 138 patients were included. There were several major types of morphological changes identified: 1) traumatic macular hole in 25 eyes. There were two types of traumatic macular hole, with and without cystoid edema in perihole retina. The group of macular hole without cystoid edema more frequently accompanied with retinal atrophy or subretinal hemorrhage (P<0.001), and the visual acuity is poorer (1.18 vs 0.87, P=0.077). 2) subretinal hemorrhage in 30 eyes. The patients of subretinal hemorrhage under fovea was older than that in periphery retina (30.5 vs 21.7year, p=0.026), and the area of hemorrhage is smaller (1.7 vs 3.6PD, P=0.001); 3) choroidal rupture in 32 eyes; 4) retinal atrophy in 70 eyes, the outer retinal atrophy caused by commotio retinae can be graded into 4 levels, the grade of atrophy was positively correlated with LogMAR best corrected visual acuity (coefficient correlation 0.528, P<0.001)and inversely with foveal thickness (coefficient correlation-0.521, P<0.001). 5) inner limiting membrane fold in 19 eyes; 6) retinal pigment epithelium tear in 2 eyes. In 47 cases (34%), there were two or more types of morphological changes in the same eye.CONCLUSIONS: In spectral domain OCT, traumatic macular hole without cystoid edema more frequently accompanied with retinal atrophy or subretinal hemorrhage. The area of traumatic retinal hemorrhage was smaller in fovea than in peripheral retina. Commotio retinae can be graded into 4 levels with spectral domain OCT and the grade is correlated with the best corrected visual acuity and fovea thickness. Ocular contusion may cause the atrophy of inner retina. Spectral domain OCT it is a valuable tool in investigation of traumatic retinopathy, as its high resolution, good sensitivity and ability of quantitative measurement.