Prediction of visual prognosis with spectral-domain optical coherence tomography in outer retinal atrophy secondary to closed globe trauma

Abstract

Purpose: To investigate the structural features of outer retinal atrophy secondary to closed globe trauma and their correlation with visual prognosis, using spectral-domain optical coherence tomography (OCT).

Methods: In this retrospective study, patients with outer retinal atrophy secondary to closed globe trauma were examined with Topcon 3D OCT-1000. The foveal thickness was measured. The severity of outer retinal atrophy was graded into three levels: disruption of inner/outer segment layer, reduced thickness of outer nuclear layer, and disappearance of outer nuclear layer. Cases with >180 days of follow-up were included. The correlations between OCT features and best-corrected visual acuity at the last follow-up were analyzed.

Results: Overall, 52 eyes of 52 patients were included, with mean follow-up of 286 ± 200 days. Spectral-domain OCT revealed disruption of the inner/outer segment layer with atrophy of outer nuclear layer and disorganization of inner retina in severe cases. The final best-corrected visual acuity significantly correlated with foveal thickness (r = -0.813; P < 0.001) and the grade of outer retinal atrophy (r = 0.796; P < 0.001).

Conclusion: Spectral-domain OCT revealed disruption of the inner/outer segment layer and atrophy of outer nuclear layer in cases of commotio retinae. Foveal thickness and grade of outer retinal atrophy were predictors for final visual outcome in these cases.