Maurice F. Rabb » Severe Commotio Retinae With Edema And Hemorrhages

Color views of the left posterior pole reveals wrinkling of the internal ending membrane with subretinal blood present inferior and temporal to the disc as well as inferior to the macula and involving the macula itself. There are areas of choroidal damage in the macular region and inferior to the macular zone. Inferior and temporal to the macular region is a large area of preretinal blood in association with intraretinal blood. There is also more blood seen directly inferior to the left disc.

Fluorescein dye transit through the left eye reveals a large area of hypofluorescence just inferior to the foveal region surrounded by an area of hyperfluorescence representing a pigment epithelial window defect. Just at the temporal end of the hypofluorescent area are two horizontal lines which appear to be compatible with choroidal ruptures. In the late venous stage, there is still no fluorescence in the center of the lesion due to both edema and subretinal blood. In the late venous stage, there are two hyperfluorescent horizontal lines inferior to the macular region which also appear to be choroidal ruptures.

IMPRESSION:
Patient has severe commotio retinae with retinal edema and retinal hemorrhages. There is also preretinal blood due to contusion of the globe.