Berlin's edema: Difference between revisions
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{{Infobox medical condition | |||
| name = Berlin's edema | |||
| synonyms = Commotio retinae | |||
| field = [[Ophthalmology]] | |||
| symptoms = [[Blurred vision]], [[visual field]] defects | |||
| complications = [[Retinal detachment]], [[macular hole]] | |||
| onset = Immediately after [[blunt trauma]] to the eye | |||
| duration = Usually resolves within weeks | |||
| causes = [[Blunt trauma]] to the eye | |||
| risks = [[Sports injuries]], [[accidents]] | |||
| diagnosis = [[Ophthalmoscopy]], [[Optical coherence tomography]] | |||
| differential = [[Retinal detachment]], [[vitreous hemorrhage]] | |||
| treatment = Observation, [[protective eyewear]] | |||
| prognosis = Generally good, but depends on severity | |||
| frequency = Common in cases of eye trauma | |||
}} | |||
{{Orphan|date=September 2015}} | {{Orphan|date=September 2015}} | ||
'''Berlin's edema''' ('''commotio retinae''') a common condition caused by blunt injury to the [[eye]].<ref name=Sheridan04>{{cite book|last=Sheridan|first=Robert L.; Lhowe, Laurel C.|title=The Trauma Handbook of the Massachusetts General Hospital|series=LWW Medical Book Collection|year=2004|publisher=Lippincott Williams & Wilkins|location=Philadelphia|isbn=978-0-7817-4596-3|page=274|url=https://books.google.com/books?id=qb0eujBTVxoC&pg=PA274}}</ref> It is characterized by decreased vision in the injured eye a few hours after the injury. Under examination the [[retina]] appears [[Opacity (optics)|opaque]] and white in colour in the [[peripheral|periphery]] but the [[blood vessels]] are normally seen along with "cherry red spot" in the foveal reigion.This whitening is indicative of cell damage,<ref>{{Cite journal|last=Park|first=S. J.|last2=Park|first2=K. H.|last3=Heo|first3=J. W.|last4=Woo|first4=S. J.|date=2014-03-01|title=Visual and anatomic outcomes of golf ball-related ocular injuries|journal=Eye|language=en|volume=28|issue=3|pages=312–317|doi=10.1038/eye.2013.283|issn=0950-222X|pmc=3965816|pmid=24384962}}</ref> which occurs in the retinal pigment epithelium and outer segment layer of photoreceptors.<ref>{{Cite book|url= |title=Chapter 140 - Trauma: Principles and Techniques of Treatment A2 - Ryan, Stephen J.|last=Recchia|first=Franco M.|last2=Aaberg Jr.|first2=Thomas|last3=Sternberg Jr.|first3=Paul|date=2006-01-01|publisher=Mosby|isbn=9780323025980|editor-last=Hinton|editor-first=David R.|location=Edinburgh|pages=2379–2401|doi=10.1016/b978-0-323-02598-0.50146-4|editor-last2=Schachat|editor-first2=Andrew P.|editor-last3=Wilkinson|editor-first3=C. P.}}</ref><ref>{{Cite journal|last=Ah-kee|first=Elliott|last2=Oladiwura|first2=Dilys|last3=Lim|first3=Lik Thai|last4=Scott|first4=Angus|date=2014-05-19|title=Macular optical coherence tomography findings following blunt ocular trauma|journal=Clinical Ophthalmology|language=English|volume= 8|pages=989–92|doi=10.2147/opth.s64082|pmid=24899795|pmc=4038424}}</ref> Damage to the outer segment often results in photoreceptor death through uncertain mechanisms.<ref>{{Cite book|url=|title=Chapter 8 - Structure and Function of Rod Photoreceptors A2 - Ryan, Stephen J.|last=Chen|first=Jeannie|last2=Geller|first2=Scott|last3=Flannery|first3=John|date=2006-01-01|publisher=Mosby|isbn=9780323025980|editor-last=Hinton|editor-first=David R.|location=Edinburgh|pages=153–170|doi=10.1016/b978-0-323-02598-0.50014-8|editor-last2=Schachat|editor-first2=Andrew P.|editor-last3=Wilkinson|editor-first3=C. P.}}</ref> Usually there is no leakage of fluid and therefore it is not considered a true [[edema]]. The [[choroidal]] [[fluorescence]] in [[fluorescent angiography]] is absent. [[Visual acuity]] ranges from 20/20 to 20/400. | |||
'''Berlin's edema''' ('''commotio retinae''') a common condition caused by blunt injury to the [[eye]].<ref name=Sheridan04>{{cite book|last=Sheridan|first=Robert L.; Lhowe, Laurel C.|title=The Trauma Handbook of the Massachusetts General Hospital|series=LWW Medical Book Collection|year=2004|publisher=Lippincott Williams & Wilkins|location=Philadelphia|isbn=978-0-7817-4596-3|page=274|url=https://books.google.com/books?id=qb0eujBTVxoC&pg=PA274}}</ref> It is characterized by decreased vision in the injured eye a few hours after the injury. Under examination the [[retina]] appears [[Opacity (optics)|opaque]] and white in colour in the [[peripheral|periphery]] but the [[blood vessels]] are normally seen along with "cherry red spot" in the foveal reigion.This whitening is indicative of cell damage,<ref>{{Cite journal|last=Park|first=S. J.|last2=Park|first2=K. H.|last3=Heo|first3=J. W.|last4=Woo|first4=S. J.|date=2014-03-01|title=Visual and anatomic outcomes of golf ball-related ocular injuries|journal=Eye|language=en|volume=28|issue=3|pages= | |||
The [[prognosis]] is excellent except in case of complications of choroidal rupture, [[hemorrhage]] or [[Melanocyte|pigment]] [[epithelial]] damage, but damage to the macula will result in poorer recovery. The outcome can be worsened in the case of [[retinal detachment]], [[atrophy]] or [[hyperplasia]]. [[Visual field defect]]s can occur. In late cases [[cystoid macular edema]] sometimes develops which can further lead to [[macular]] destruction. | The [[prognosis]] is excellent except in case of complications of choroidal rupture, [[hemorrhage]] or [[Melanocyte|pigment]] [[epithelial]] damage, but damage to the macula will result in poorer recovery. The outcome can be worsened in the case of [[retinal detachment]], [[atrophy]] or [[hyperplasia]]. [[Visual field defect]]s can occur. In late cases [[cystoid macular edema]] sometimes develops which can further lead to [[macular]] destruction. | ||
Commotio retinae is usually [[self-limiting (biology)|self limiting]] and there is no treatment as such. It usually resolves in | Commotio retinae is usually [[self-limiting (biology)|self limiting]] and there is no treatment as such. It usually resolves in 3–4 weeks<ref>{{Cite journal|last=Ghazanfari-Nasrabad|first=Mahdi|last2=Amrollahi-Sharifabadi|first2=Mohammad|last3=Kargar-Bideh|first3=Omidreza|last4=Azizi-Sharifabad|first4=Saeed|date=2016-01-01|title=Permanent Ocular Injury Following Paintball Pellet Hit: A Medicolegal Case|journal=Journal of Forensic Sciences|language=en|volume=61|issue=1|pages=277–279|doi=10.1111/1556-4029.12917|pmid=26211673|issn=1556-4029}}</ref> without any [[Complication (medicine)|complications]] and [[sequelae]]. | ||
==References== | ==References== | ||
{{Reflist}} | {{Reflist}} | ||
[[Category:Disorders of choroid and retina]] | [[Category:Disorders of choroid and retina]] | ||
{{injury-stub}} | {{injury-stub}} | ||
{{eye-disease-stub}} | {{eye-disease-stub}} | ||
{{dictionary-stub1}} | {{dictionary-stub1}} | ||
Latest revision as of 00:08, 4 April 2025
| Berlin's edema | |
|---|---|
| Synonyms | Commotio retinae |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Blurred vision, visual field defects |
| Complications | Retinal detachment, macular hole |
| Onset | Immediately after blunt trauma to the eye |
| Duration | Usually resolves within weeks |
| Types | N/A |
| Causes | Blunt trauma to the eye |
| Risks | Sports injuries, accidents |
| Diagnosis | Ophthalmoscopy, Optical coherence tomography |
| Differential diagnosis | Retinal detachment, vitreous hemorrhage |
| Prevention | N/A |
| Treatment | Observation, protective eyewear |
| Medication | N/A |
| Prognosis | Generally good, but depends on severity |
| Frequency | Common in cases of eye trauma |
| Deaths | N/A |
Berlin's edema (commotio retinae) a common condition caused by blunt injury to the eye.<ref name=Sheridan04>Robert L.; Lhowe, Laurel C.,
The Trauma Handbook of the Massachusetts General Hospital. online version, Philadelphia:Lippincott Williams & Wilkins, 2004, Series: LWW Medical Book Collection, ISBN 978-0-7817-4596-3,</ref> It is characterized by decreased vision in the injured eye a few hours after the injury. Under examination the retina appears opaque and white in colour in the periphery but the blood vessels are normally seen along with "cherry red spot" in the foveal reigion.This whitening is indicative of cell damage,<ref>Park, S. J., Visual and anatomic outcomes of golf ball-related ocular injuries, Eye, Vol. 28(Issue: 3), pp. 312–317, DOI: 10.1038/eye.2013.283, PMID: 24384962, PMC: 3965816,</ref> which occurs in the retinal pigment epithelium and outer segment layer of photoreceptors.<ref>Franco M., Chapter 140 - Trauma: Principles and Techniques of Treatment A2 - Ryan, Stephen J., Edinburgh:Mosby, ISBN 9780323025980, DOI: 10.1016/b978-0-323-02598-0.50146-4, Pages: 2379–2401,</ref><ref>Ah-kee, Elliott, Macular optical coherence tomography findings following blunt ocular trauma, Clinical Ophthalmology, Vol. 8, pp. 989–92, DOI: 10.2147/opth.s64082, PMID: 24899795, PMC: 4038424,</ref> Damage to the outer segment often results in photoreceptor death through uncertain mechanisms.<ref>Jeannie, Chapter 8 - Structure and Function of Rod Photoreceptors A2 - Ryan, Stephen J., Edinburgh:Mosby, ISBN 9780323025980, DOI: 10.1016/b978-0-323-02598-0.50014-8, Pages: 153–170,</ref> Usually there is no leakage of fluid and therefore it is not considered a true edema. The choroidal fluorescence in fluorescent angiography is absent. Visual acuity ranges from 20/20 to 20/400.
The prognosis is excellent except in case of complications of choroidal rupture, hemorrhage or pigment epithelial damage, but damage to the macula will result in poorer recovery. The outcome can be worsened in the case of retinal detachment, atrophy or hyperplasia. Visual field defects can occur. In late cases cystoid macular edema sometimes develops which can further lead to macular destruction. Commotio retinae is usually self limiting and there is no treatment as such. It usually resolves in 3–4 weeks<ref>Ghazanfari-Nasrabad, Mahdi,
Permanent Ocular Injury Following Paintball Pellet Hit: A Medicolegal Case, Journal of Forensic Sciences, Vol. 61(Issue: 1), pp. 277–279, DOI: 10.1111/1556-4029.12917, PMID: 26211673,</ref> without any complications and sequelae.
References[edit]
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