Hyporeflective micro-elevations and irregularity of the ellipsoid layer: novel optical coherence tomography features...

To report on the anatomical changes at the macula in patients with commotio retinae (CR) and not accompanied by any other types of traumatic maculopathy.

Retrospective, observational case series.

In this study, individuals with history of blunt ocular trauma and having CR involving the macula without any other type of traumatic maculopathy were included.

Participants were evaluated with ophthalmic examination, visual acuity testing, and spectral domain optical coherence tomography (OCT) at presentation and further follow-up visits.

On colour fundus photography, grey-white retinal discolouration was identified in all 16 patients and 1 patient had accompanying inferior vitreous hemorrhage. On OCT imaging, hyper-reflectivity of the ellipsoid zone (EZ) with disappearance of the thin hyporeflective optical space was noted in all 16 patients at presentation. One patient showed focal hyporeflective micro-elevation of the EZ (MEEZ) at presentation. Final follow-up visit ranged from 6 to 54 days (mean 19.5 days). Complete resolution of CR was noted in 14 eyes at the final visit. Focal hyporeflective MEEZ was noted in 11 eyes at the final follow-up visit. The number of eyes with irregular ellipsoid layer was 5 at the final follow-up visit.

In eyes with CR involving the macula, 2 new OCT features were identified, namely, irregular ellipsoid layer and focal hyporeflective MEEZ. These OCT findings did not affect the vision. Further studies with histological evidence would be required in future to establish the pathogenesis of CR involving the macula.