Bacillary layer detachment in acute nonpenetrating ocular trauma.

OBJECTIVE

To study the clinical and visual outcomes of patients presenting with bacillary layer detachment (BLD) on optical coherence tomography (OCT) in blunt ocular trauma.

DESIGN

Retrospective observational study.

PARTICIPANTS

Clinical fundus photographs and OCT scans with Spectralis machine were reviewed to identify patients with blunt ocular trauma showing BLD.

METHODS

Patients were further analyzed for changes in their anatomic features such as subretinal hemorrhage, intrabacillary layer bleed. subretinal fibrosis and choroidal rupture and reattachment of BLD, and visual outcomes over subsequent follow-up visits.

RESULTS

Of a total of 77 eyes with blunt ocular trauma, 6 (8%) eyes with BLD were identified. All patients were male with presenting visual acuity ranging from 6/9 to 2/60 (mean logMAR = 1.119; Snellen's equivalent = 20/263). The time interval between trauma and presentation ranged from 1 to 7 days. Subretinal hemorrhage and choroidal rupture were noted in all 6 eyes. On OCT, foveal involvement by the BLD was noted in 5 eyes. Intrabacillary layer hemorrhage was noted in all patients. Reattachment of the bacillary layer and visual acuity improvement were noted in all eyes at the final visit. The time interval for resolution of BLD ranged from 2 to 10 days. Visual acuity of 6/36 or less was secondary to subretinal fibrosis close to the fovea and subfoveal choroidal rupture.

CONCLUSION

BLD in blunt ocular trauma is a rare finding, shows complete resolution, and appears not to influence visual or anatomic outcome.