Fundus autofluorescence in patients with blunt ocular trauma

To report fundus autofluorescence and optical coherence tomography (OCT) findings in patients with blunt ocular trauma.

Six eyes of six consecutive patients with blunt ocular trauma were evaluated in an observational case series using colour fundus photography, the Heidelberg Retina Angiograph 2 (HRA2) system for fundus autofluorescence (FAF) and OCT (Stratus OCT).

Three patients presented with secondary retinal pigment epitheliopathy that was identified as a reduced FAF plaque with interposed increased FAF granular smaller lesions. These findings were not as evident in fundus examination and colour photography in two patients. Visual field in one patient showed a decreased area of sensitivity that correlated to the reduced/increased autofluorescent lesion. The other three patients had subretinal haemorrhage and choroidal rupture, which appeared with a reduced FAF with an increased FAF rim after resolution. OCT demonstrated a choriocapillaris/ retinal pigment epithelium (RPE) complex disruption and its resolution over time in all patients with choroidal rupture.

Damaged RPE area was more evident and better delineated by FAF imaging compared with fundus examination and fundus photography alone. Autofluorescence imaging might be a useful exam to show the length and severity of post-traumatic retinal lesions and it may add relevant information in the global evaluation of blunt ocular trauma complications. Moreover, OCT added valuable information to the diagnosis and progression of choroidal rupture. Further studies to determine the predictive value of FAF in ocular blunt trauma are warranted.