Long-term outcomes of acute traumatic maculopathy

To report immediate and long-term outcomes of acute traumatic maculopathy.

Retrospective case series. Acute traumatic maculopathy was defined as a macular opacification after blunt trauma. Patients were examined at presentation, 1 week, and 6 months. Retinography and time-domain and spectral-domain optical coherence tomographies were performed in all patients. Central macular thickness, the qualitative aspect of the macular profile, and retinal nerve fiber layer thickness were assessed. Multifocal electroretinography was performed at presentation and after 6 months.

Twenty patients (20 eyes) were studied. Their mean age was 20.8 years, and the initial visual acuity was 20/100. In all cases, initial optical coherence tomographies revealed an increase in reflectivity of the inner and outer segment junction, with an apposition of the latter to the retinal pigment epithelium. Optical coherence tomography profiles were back to normal at the 1-week visit. Initial multifocal electroretinography performed in six patients showed a decrease in amplitudes in the central area but not in the periphery. There was no delay in latency. Similar electroretinal dysfunction persisted after 6 months.

Macular opacification observed in acute traumatic maculopathy is associated with an increase in reflectivity of the inner and outer segment photoreceptor junction on optical coherence tomography. Although visual recovery is excellent, reduction in the electroretinal activity observed 6 months after the trauma suggests that the retina does not fully recover from the initial disorganization of its external layers.