retinal concussion
Introduction
Introduction to retinal oscillation Remotioretina (commotioretinae) refers to transient retinal edema that occurs in the posterior pole after contusion, whitening of the retina, and decreased vision. Due to retinal shock caused by blunt trauma of the eyeball, there are two types of non-direct and direct. The blunt force impacts the anterior segment of the eyeball, and the pressure wave is transmitted through the interstitial space of the ball, acting on the posterior pole, causing edema of the macular edema, which is the most common non-direct retinal concussion. Because Berlin first proposed in 1873, it is also known as Berlin edema. If the blunt force impacts on the side of the eyeball (no wall rupture), the blunt force directly acts on the corresponding retina, see a round or radial large gray-white turbidity, called direct retinal oscillation. However, the eyeball is protected by the humerus, and the chance of blunt injury is much less than that of the anterior segment of the eyeball. Moreover, this damage is generally in the periphery of the retina and generally has little effect on vision and is often ignored. Retinal concussion occurs several hours after trauma, and central visual impairment varies with the degree of macular edema. The light is close to normal, with variable or small vision, and severe with high obstacles. basic knowledge The proportion of sickness: 0.0031% Susceptible people: good for teenagers Mode of infection: non-infectious Complications: retinal detachment
Cause
Cause of retinal concussion
After the injury, transient retinal edema appeared in the posterior pole, the retina turned white, and vision decreased. The shock wave transmitted from the affected part damages the outer retina, the pigment epithelium is damaged, the barrier function is destroyed, and the extracellular edema makes the retina turbid.
Prevention
Retinal oscillation prevention
Children and adolescents in this disease are more common, mostly for various kinds of ball, slingshot, fist and firecrackers. Therefore, parents and schools should cooperate with each other to educate students and their children to do preventive work.
Complication
Retinal concussion complications Complications
Patients with severe retinal concussion recover slowly and may cause retinal detachment.
Symptom
Retinal concussion symptoms common symptoms visual impairment macular cystic edema retinal hemorrhage
After the contusion, transient retinal edema appeared in the posterior pole, the retina turned white, and vision decreased. The shock wave transmitted by the affected part damages the outer retina, the pigment epithelium is damaged, the barrier function is destroyed, the extracellular edema makes the retina turbid, and the visual acuity can be reduced to 0.1. Can be mainly expressed as two kinds of endings.
1 In some cases, after 3-4 weeks of edema subsided, vision recovery was better, belonging to "retina shock".
2 and some have obvious photoreceptor damage, degeneration and necrosis of the outer layer of the retina, pigmentation disorder of the macula, and obvious loss of vision, which may be called "retinal contusion". Severe can also be accompanied by retinal hemorrhage.
Examine
Retinal shock examination
Under the ophthalmoscope, the posterior part of the fundus is milky white and turbid, and the macula is more prominent. This is due to the fact that the macular subretinal choroidal capillaries are very rich, and the reactive vasodilatation and hyperemia are correspondingly significant. In addition, the yellow spots have thicker Henle fibers, and the leakage fluid can be accumulated in a large amount. In the central avascular zone of the macula (the fovea of the macula), the retina is thin and lacks edema, so the choroidal color is still exposed, and the cherry erythema similar to the central retinal artery occlusion is present under the setting of the surrounding milky white turbidity. The retinal edema is turbid and gradually subsides within a few days to several weeks. Generally, no trace is left and vision is restored.
Diagnosis
Retinal shock diagnosis
Diagnostic points
1. There is a history of eye contusion. After a few hours, I feel that the object is unclear and the object is deformed.
2, fundus examination can be seen in the posterior pole, especially the macular retinal edema.
3, retinal concussion changes in the fundus is similar to the fundus changes of retinal artery embolization, should be identified. The latter has no history of trauma, sudden onset, complete loss of vision or only a sense of light, and a history of hypertension and cardiovascular disease.
Differential diagnosis
Identification with retinopathy.
