Outer retinal structure after closed-globe blunt ocular trauma.
Outer retinal structure after closed-globe blunt ocular trauma.
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DOI：
10.1097/iae.0000000000000169
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发表时间：
2014-10
期刊：
影响因子：
--
通讯作者：
Carroll J
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文献类型：
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作者：
Flatter JA;Cooper RF;Dubow MJ;Pinhas A;Singh RS;Kapur R;Shah N;Walsh RD;Hong SH;Weinberg DV;Stepien KE;Wirostko WJ;Robison S;Dubra A;Rosen RB;Connor TB Jr;Carroll J
评价闭合性地球仪钝性眼外伤（cgBOT）后视力障碍患者的视网膜外部结构异常。9名受试者的视力投诉后cgBOT之间的1个月创伤后和6年创伤后进行了检查。光谱域光学相干断层扫描（SD-OCT）用于评估外部视网膜结构，而自适应光学扫描光检眼镜（AOSLO）用于分析感光细胞镶嵌完整性。视力缺陷范围从中心暗点到视力下降。SD-OCT缺陷包括局灶性中央凹感光细胞病变、交错区的可变衰减和外节带的斑点，其中1例受试者具有正常的外部视网膜结构。AOSLO显示所有受试者的光感受器镶嵌中断，表现为中心凹焦点不连续性、中心凹周围低反射锥体和选择性锥体损失的旁中心区域。我们观察到持续的外部视网膜破裂的受试者与视觉投诉后cgBOT，虽然在一个变量的程度。AOSLO成像允许在使用SD-OCT或其他当前临床成像工具无法分辨的细节水平上评估感光器结构。多模态成像似乎有助于揭示cgBOT后患者视觉投诉的原因。未来的研究需要更好地了解感光细胞结构如何纵向变化，以应对各种创伤。
To evaluate outer retinal structural abnormalities in patients with visual deficits following closed globe blunt ocular trauma (cgBOT). Nine subjects with visual complaints following cgBOT were examined between 1 month post-trauma and 6 years post-trauma. Spectral domain optical coherence tomography (SD-OCT) was used to assess outer retinal architecture, while adaptive optics scanning light ophthalmoscopy (AOSLO) was used to analyze photoreceptor mosaic integrity. Visual deficits ranged from central scotomas to decreased visual acuity. SD-OCT defects included focal foveal photoreceptor lesions, variable attenuation of the interdigitation zone, and mottling of the outer segment band, with one subject having normal outer retinal structure. AOSLO revealed disruption of the photoreceptor mosaic in all subjects, variably manifesting as foveal focal discontinuities, perifoveal hyporeflective cones, and paracentral regions of selective cone loss. We observe persistent outer retinal disruption in subjects with visual complaints following cgBOT, albeit to a variable degree. AOSLO imaging allows assessment of photoreceptor structure at a level of detail not resolvable using SD-OCT or other current clinical imaging tools. Multimodal imaging appears useful for revealing the cause of visual complaints in patients following cgBOT. Future studies are needed to better understand how photoreceptor structure changes longitudinally in response to various trauma.