A 14-year-old boy presented immediately after injury to the left eye. Examination of the left eye showed a total hyphema which cleared in seven days and vision improved to 6/9. Fundus examination revealed whitish yellow curvilinear lesion and sub-retinal blood []. The right eye was normal.\nSSOCT done seven days post injury showed discontinuity in the RPE/BM complex [] in one area, and there was blood lifting the ellipsoid and ELM layers. The ellipsoid layer was intact over the area but appeared less defined and thicker compared to adjacent ellipsoid layer. The defect in RPE/BM complex was 195 μm. Except for the innermost layers of the choriocapillaries, the outer choriocapillaries and the outer two layers of the choroidal vasculature seemed to be intact. In another area with sub-retinal blood, there was a gap in the RPE/ BM complex measuring about 454 μm []. One edge of the defect was shadowed by the retinal blood vessel over the region.\nOCT done through the same area as in 6 weeks later showed that gap in the RPE/BM complex was bridged with hyper-reflective reparative tissue and this tissue had incorporated the ellipsoid layer, ELM, and part of the outer nuclear layer in it and disrupted them. Some tissue proliferation was seen at the choriocapillary level too [].
A 48-year-old male obtained a whiplash neck injury and a fracture of the articulate processes of the 7th neck vertebrae from a traffic accident. Two days later, he reported blurred vision in the left eye (LE). Although the best corrected visual acuity (BCVA) was 20/25, Amsler grid test was positive. There was preretinal paramacular hemorrhage on fundus examination. OCT, OCTA, visual field (VF) examination, fluorescein angiography (FA), and multifocal electroretinogram (mfERG) were performed. To analyze foveal structure and thickness, we utilized a swept-source (SS)-OCT and OCTA system (Triton, Topcon, Tokyo, Japan). The central retinal thickness (CRT) was defined as the average thickness in the central circle area. For OCTA, 4.5 × 4.5 × 4.5 mm3 macular cubes were obtained. En face images of the retinal vasculature were created from the superficial capillary layer (SCL) and deep capillary layer (DCL), based on the automated layer segmentation. The FAZ area was defined as the area inside the central border of the capillary network and was manually delineated on the inner border using the standard software and then calculated automatically. VF was measured in macular program (M program, Octopus 900, Haag-Streit, USA) and mfERG and FA (Canon) were performed accordingly. OCT showed no fluid but a slight disruption of the outer plexiform layer (OPL), outer nuclear layer (ONL), retinal pigment epithelial (RPE) layer, and photoreceptors (PR) with hyper-reflectivity of the ellipsoid zone (EZ) and interdigitation zone (IZ) and remained unchanged throughout the 1-year follow-up (Fig. ). CRT was 241 and 257 μm for the LE and RE, respectively. VF showed fixed central scotoma (Fig. ). mfERG was unremarkable. FA revealed late paramacular hyperfluorescence in both eyes. OCTA showed an enlarged FAZ area in the SCL of 334,402 μm2 in the LE as compared to 253,521 μm2 in the RE, as well as in the DCL, measuring 814,944 μm2 in the LE as compared to 311,858 μm2 in the RE, respectively (Fig. ).