Selective rod outer segment disruption in commotio retinae - a finding identified on Multicolour® Imaging

Area of Science:

• Ophthalmology
• Retinal Imaging
• Traumatic Eye Injury

Background:

• Commotio retinae (CR) is a transient condition affecting the outer retina following blunt trauma.
• Accurate assessment of CR, particularly macular involvement, is crucial for understanding visual prognosis.
• Optical coherence tomography (OCT) and Multicolour® imaging (MCI) are advanced imaging modalities for retinal evaluation.

Purpose of the Study:

• To characterize Multicolour® imaging (MCI) findings in commotio retinae (CR) involving the macula.
• To correlate MCI findings topographically with outer retinal layer changes observed on optical coherence tomography (OCT).
• To investigate the incidence and pattern of foveal sparing in macular CR.

Main Methods:

• Retrospective analysis of 16 eyes with macular CR, imaged using both OCT and MCI.
• Exclusion of participants with other forms of traumatic maculopathy.
• Correlation of OCT findings (ellipsoid zone and interdigitation zone integrity) with MCI features (reflectance patterns).

Main Results:

• OCT revealed obliteration and increased reflectivity of the ellipsoid zone (EZ) and interdigitation zone (IZ) in CR regions, with foveal sparing.
• MCI demonstrated hyperreflective white areas corresponding to CR, with unaffected foveal reflectance.
• Affected EZ and IZ on OCT correlated with increased reflectance on MCI's individual color channels; resolution of MCI changes observed within 1 week in follow-up cases.

Conclusions:

• Macular commotio retinae commonly spares the fovea, with affected areas primarily in rod-dominated regions.
• MCI effectively visualizes CR-related hyperreflectance, correlating with outer retinal layer disruption seen on OCT.
• Future research combining MCI with electrophysiology and adaptive optics imaging is recommended for comprehensive understanding.