SCIENTIFIC POSTER_Miriam Garcia Fernandez_1

Advantages:

To report a case of unilateral traumatic retinopathy due to a whiplash injury and its long-term course.

Methods:

A 62-year-old man was involved in a traffic accident and had a history of flexion-extension and neck trauma, but no bone injury or thorakic compression by the seatbelt. He noticed an immediate moderate visual deterioration in his right eye, which remained unchanged. One year after the accident, he was referred to our clinic. Complete clinical examination with best-corrected visual acuity (Snellen scale), anterior and posterior segment biomicroscopy, fundus photography, fluorescein angiography (FA) and optical coherence tomography (OCT) was performed.

Effectiveness/safety:

At initial presentation, VA was 0.3 (decimal scale) in the right eye and 1.0 in the left eye. Anterior segment findings were normal. Ophthalmoscopy revealed a small yellowish lesions in the fovea with loss of the normal foveal reflex. FA showed localized leakage from a vessel superior to the fovea. OCT showed a disruption of external retinal layers (IS/OS: internal segments and outer segments of photoreceptors and ELMĀ : external limiting membrane) with a hyperreflective lesion under the ELM. Control examination 20 months later showed no functional and anatomic changes.

Conclusions:

Pathogenesis of the fundus findings described must remain hypothetical. Local microcirculatory disturbances are postulated as the cause of the retinopathy described. This has to be distinguished from other traumatically-induced retinopathies, e.g. Purtscher’s retinopathy which was largely ruled out because of the clinical presentation and the lack of a thorakic trauma or bone fracture. Other possibilities are a traumatically induced posterior vitreous detachment at the macular site that has lead to a foveal photoreceptor cell damage. Retinal microchanges after whiplash injure may be underdiagnozed. Diagnosis and follow-up examinations are important for the patient and possibly also of medico-legal significance.