Traumatic retinal angiopathy--associated with wearing of car seat belts.

Three patients who were involved in road traffic accidents and sustained seat belt related injuries developed a retinal angiopathy characterised by retinal haemorrhage, oedema and focal ischaemia. Significant unilateral visual loss (2/60 - 6/18) was reported 1-48 hours following injury and central or paracentral annular scotomata were present. Although there was good recovery of visual acuity all patients had permanent scotomata, colour vision defects and loss of contrast sensitivity. Residual retinal microvascular and haemodynamic changes were noted on fluorescein angiography and the visually evoked responses were uniformly depressed. The structural and functional alterations in the retina of patients who have sustained seat belt injuries have important medico-legal implications.