Traumatic Airbag Maculopathy

Abstract

pigment epithelial atrophy, the patient was managed conservatively. Follow-up at 4 months showed spontaneous resolution of the subretinal fluid on optical coherence tomography (Figure 1C); visual acuity had returned to 6/60 OS but the macular hole remained open. Four months later, the patient's vision remained stable but the subretinal fluid had returned. An inverse pseudohypopyon was visible at the macula (Figure 2), and optical coherence tomography now demonstrated the presence of droplet-like particles suggestive of emulsified silicone oil (Figure 1D). The patient declined further intervention. Posturing did not appear to affect the distribution of the oil. Comment. Silicone oil is a commonly used intraocular tamponade in the surgical management of giant retinal tear. Subretinal silicone oil is a rare but serious complication that can result in loss of internal tamponade and subsequent failure of retinal detachment repair. Silicone oil can migrate into any open retinal break, particularly if the surrounding retina is detached. The delayed presentation of subretinal silicone oil has been described in cases of retinal detachment associated with optic disc pit. 4 We believe that this is the first description of emulsified submacular silicone oil presenting as an inverse pseudohypopyon. It is unclear when the macular hole formed and therefore whether the emulsified silicone oil passed through a newly formed macular hole into the subretinal space or whether subretinal silicone oil migrated to the posterior pole over time. It is possible that emulsification along the posterior oil interface may have allowed tiny droplets to enter the hole, thereby contributing to retinal detachment. Recent imaging studies have observed that silicone oil can pass through an open macular hole under certain postural conditions. 5 It is interesting to note that the level of visual acuity is relatively well preserved despite the possibility that the oil might have been present in the subretinal space for many years. We postulate that the spontaneous accumulation and resolution of submacular fluid suggest a dynamic process whereby the emulsified oil might act to intermittently close the macular hole, allowing the retinal pigment epithelial pump to clear the fluid when an effective seal is present. We do not have any images to confirm this. This case demonstrates a novel clinical entity that raises further questions about how silicone oil can behave within the eye.

Unusual bilateral traumatic maculopathy following whiplash injury

“…In particular serous retinopathy associated with neurosensory detachment is a rare occurrence 4 5. Although the neurosensory detachment in our case was extensive, the anatomy of the inner retina and particularly the IS/OS junction was preserved, which is consistent with the rapid improvement of VA and mfERG activity.…”

Corneal stromal damage through the eyelid after tightening using intense focused ultrasound

“…8 Airbag deployment in road traffic accidents has also been associated with retinal findings such as cotton wool spots, subretinal fluid, and impending macular hole, along with persistent central visual disturbance, which again were not seen in our case presentation. 9 In summary, the clinical presentation and ocular findings noted in our case appear distinct from other such ophthalmic manifestations of trauma, making this a unique and instructive report. A discussion of the potential pathophysiology of the bilateral macular edema in this case is difficult given the absence of fundus fluorescein angiography.…”

Central visual loss following a motor vehicle accident: traumatic airbag maculopathy

“…The postulated cause of the specific injury of TAM relates to the acceleration–deceleration forces resulting in retinal dehiscence 2 , 3 . The forces involved may cause blunt trauma to the ocular tissue, due to the airbag inflating in one direction and the head moving in the opposite direction at high velocity.…”