Abstract
Objective
To study the clinical and visual outcomes of patients presenting with bacillary layer
detachment (BLD) on optical coherence tomography (OCT) in blunt ocular trauma.
Design
Retrospective observational study.
Participants
Clinical fundus photographs and OCT scans with Spectralis machine were reviewed to
identify patients with blunt ocular trauma showing BLD.
Methods
Patients were further analyzed for changes in their anatomic features such as subretinal
hemorrhage, intrabacillary layer bleed. subretinal fibrosis and choroidal rupture
and reattachment of BLD, and visual outcomes over subsequent follow-up visits.
Results
Of a total of 77 eyes with blunt ocular trauma, 6 (8%) eyes with BLD were identified.
All patients were male with presenting visual acuity ranging from 6/9 to 2/60 (mean
logMAR = 1.119; Snellen's equivalent = 20/263). The time interval between trauma and
presentation ranged from 1 to 7 days. Subretinal hemorrhage and choroidal rupture
were noted in all 6 eyes. On OCT, foveal involvement by the BLD was noted in 5 eyes.
Intrabacillary layer hemorrhage was noted in all patients. Reattachment of the bacillary
layer and visual acuity improvement were noted in all eyes at the final visit. The
time interval for resolution of BLD ranged from 2 to 10 days. Visual acuity of 6/36
or less was secondary to subretinal fibrosis close to the fovea and subfoveal choroidal
rupture.
Conclusion
BLD in blunt ocular trauma is a rare finding, shows complete resolution, and appears
not to influence visual or anatomic outcome.
Objectif
Examiner les résultats cliniques et visuels des patients présentant un décollement
de la couche bacillaire (BLD) à la tomographie par cohérence optique (OCT) au décours
d'un traumatisme oculaire à globe fermé.
Nature
Étude d'observation rétrospective.
Participants
On a passé en revue des photographies cliniques du fond d’œil et des images d'OCT
obtenues à l'aide de l'appareil Spectralis® afin d'identifier des patients qui ont
subi un traumatisme oculaire à globe fermé ayant donné lieu à un BLD.
Méthodes
Les patients ont également été examinés afin de mettre au jour des modifications de
leurs caractéristiques anatomiques (notamment hémorragie sous-rétinienne, hémorragie
de la couche bacillaire, fibrose sous-rétinienne, rupture de la choroïde et recollement
de la couche bacillaire) et de rendre compte des résultats visuels au cours des visites
de suivi subséquentes.
Résultats
Sur un total de 77 yeux ayant subi un traumatisme oculaire à globe fermé, 6 yeux (8
%) avaient subi un BLD. L'acuité visuelle de ces patients, tous de sexe masculin,
s’échelonnait de 6/9 à 2/60 (logMAR moyen = 1,119; équivalent sur l’échelle de Snellen
= 20/263). Le délai entre le traumatisme et la visite initiale variait de 1 à 7 jours.
On a observé une hémorragie sous-rétinienne et une rupture de la choroïde dans les
6 yeux. Selon les images d'OCT, le BLD atteignait la fovéa dans 5 yeux. Tous les patients
ont subi une hémorragie de la couche bacillaire. Le recollement de la couche bacillaire
et une amélioration de l'acuité visuelle ont été notés dans tous les yeux lors de
la visite finale. Le délai avant le recollement de la couche bacillaire s'est échelonné
de 2 à 10 jours. Une acuité visuelle de 6/36 ou moins tenait à la présence d'une fibrose
sous-rétinienne près de la fovéa et à une rupture de la choroïde sous-fovéale.
Conclusion
Le BLD au décours d'un traumatisme oculaire à globe fermé est rare, se résorbe complètement
et ne semble pas avoir de répercussions sur les résultats visuels et anatomiques.
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Article info
Publication history
Published online: June 27, 2021
Identification
Copyright
© 2021 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
