Berlin's edema

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

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