Contents
Commotio retinae is an acute traumatic retinopathy characterized by retinal opacification due to breakdown of the blood-retinal barrier and a decrease in best-corrected visual acuity (BCVA).
- Berlin’s edema: Commotio retina at macula
History:
Commotio retinae, a condition caused by a direct ocular injury, was first described by Berlin in 1873 and when it involves the macula it is called Berlin’s edema. Commotio retinae is characterized by a transiently whitish coloration which is comparatively well-defined on the retina.
There have been a few histological studies into why a whitish coloration occurs. Berlin suggested that the whitish coloration might occur due to extracellular edema . In recent reports however, extracellular edemas were not observed. The disruption or fragmentation of the photoreceptor outer segment (OS) of the retina is the most common finding in histological studies of commotio retinae.
Aetiology
Blunt trauma:
Blunt force transmitted to the retina due to rapid deceleration of ocular tissues.
Clinical features
- Poor long-term visual acuity
Diagnosis
Optical coherence tomography (OCT):
Imaging various macular and chorioretinal pathological changes, particularly in acute traumatic maculopathy
- Outer photoreceptor disruption
- Oedema within outer nuclear layer
Management
Intravitreal triamcinolone acetonide (IVTA)