Severe Macular Edema after Traumatic Head Injury: A Case of Whiplash Maculopathy.

Abstract

Whiplash or "traumatic" maculopathy is associated with retinal concussion, typically following the rapid acceleration/deceleration experienced in motor vehicle collisions. It has rarely been discussed in the literature, likely given the spontaneous and relatively rapid nature with which the acute macular edema resolves. A focused clinical history around the trauma, as well as characteristics signs and structural features on retinal imaging, help to distinguish this condition from other sequelae of concussive retinal injury. We report a case of whiplash maculopathy following a blunt injury to the head, which presented with unilateral and substantial macular edema in the left eye. Case report. A 38 year old male presented with complaint of a central scotoma in his left eye following a blunt trauma to his head. Comprehensive ophthalmological evaluation and retinal imaging with optical coherence tomography (OCT) confirmed whiplash maculopathy, with acute macular edema in his left eye. Management with observation and close follow-up showed rapid improvement in his visual symptoms over the course of days, and improvements in the severity of macular edema. One month following his injury, macular edema had resolved with only mild irregularities, the patient's vision had improved and he was asymptomatic. When observing patients with significant macular edema following concussive head injury, whiplash maculopathy should be considered, regardless of the history of motor vehicle collision. The condition can present with significant asymmetry of disease. The diagnosis generally carries a good prognosis for vision; however, there are cases of persistent central visual disturbances.