Reversible cone photoreceptor injury in commotio retinae of the macula.

PURPOSE

To examine the foveal cone photopigment kinetics in two patients with commotio retinae of the posterior pole (Berlin edema).

METHODS

A noninvasive technique, called fundus reflection densitometry, was used to provide a measure of the amount of visual photopigment at the foveal area and the time constant of photopigment regeneration.

RESULTS

Strongly impaired foveal cone photopigment kinetics were found in two patients during the acute stage of commotio retinae. Complete recovery occurred within 3 months in both patients.

CONCLUSION

Retinal opacification in Berlin edema is accompanied by a traumatic lesion at the level of the photoreceptor-retinal pigment epithelium (RPE) complex. These results support recent histopathologic data on commotio retinae, which revealed moderate photoreceptor outer segment disruption and retinal pigment epithelium damage. According to our data, such damage might be reversible.