Abstract
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 148 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.
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Rutherford WH, Greenfield AA, Hayes HRM, Nelson JK : The medical effects of seat belt legislation in the United Kingdom. Department of Health & Social Security Office of the Chief Scientist. Research Report No. 13. London: HMSO 1985.
Johnston PB and Armstrong MJF : Eye injuries in Northern Ireland two years after seat belt legislation. Br J Ophthalmol, 1986; 70: 460–2.
Trinca GW and Dooley BJ : Effects of seat belt legislation on road traffic accidents. Aust NZ J Surg, 1977, 47: 150–5.
Hall NF, Denning AM, Elkington AR, Cooper PJ : The eye and the seat belt in Wessex. Br J Ophthalmol, 1985; 69: 317–9.
Dajee H and MacDonald AC : Gastric rupture due to seat belt injury. Br J Surg, 1982; 69: 436–7.
Denis P, AIlard M, Atlas H, Farmouh E : Changing trends with abdominal injuries in seat belt wearers. J Trauma, 1983; 23: 1007–8.
Hoare GW : Traumatic retinal angiopathy resulting from chest compression by safety belt. Br J Ophthalmol, 1970; 54: 667–9.
Beckinsale AB and Rosenthal AR : Early fundus fluorescein angiographic findings and sequelae in traumatic retinopathy: Case report. Br J Ophthalmol, 1983; 67: 119–23.
Kelley JS : Purtscher's retinopathy related to chest compression by safety belts: Fluorescein angiographic findings. Am J Ophthalmol, 1972, 74: 278–83.
Srebro R and Wright WW : Visually evoked potential to pseudorandom binary stimulation. Preliminary clinical trials. Arch Ophthalmol, 1980; 98: 296–8.
Purtscher O : Noch unbekannte Befunde nach Schadeltrauma. Ber Versamml Deutschen Ophthalmol. Gesell, 1910; 36: 292–307.
Teichmann KD and Gronemeyer U : Unilateral morbus Purtscher with poor visual outcome. Ann Ophthalmol, 1981; 13: 1295–99.
Lyle DJ, Stapp JP, Button RR : Ophthalmological hydrostatic pressure syndrome. Am J Ophthalmol, 1957; 44: 652–7.
Madsen PH : Traumatic retinal angiopathy. Acta Ophthalmol, 1965; 43: 776–86.
Urbanek J : Uber Fettembolie des Auges. Albrecht von Graefes Arch Ophthalmol, 1934; 131: 147–73.
Yanagisawa Y, Iwata T, Murase I, Tsurimaki Y : Ophthalmological findings in five cases of systemic fat embolism syndrome. Folio Ophthalmol Jpn, 1985; 36: 590–5.
Jacob HS, Goldstein IM, Shapiro I, Craddock PR, Hammerschmidt DE, Weissman G : Sudden blindness in acute pancreatitis. Possible role of complement-induced retinal leukoembolization. Arch Intern Med, 1981; 141: 134–6.
Inkeles DM, Walsh JH, Matz R : Purtscher's retinopathy in acute pancreatitis. Am J Med Sci, 1976; 272: 335–8.
Marr WG and Marr EG : Some observations on Purtscher's disease: traumatic retinal angiopathy. Am J Ophthalmol, 1962; 54: 693.
Anderson WC : Purtscher's retinopathy. Am J Ophthalmol, 1951; 34: 1114.
Frandsen E : Purtscher's disease. Nord Med, 1956, 56: 1097–8.
Kearns TP : Fat embolism of the retina. Demonstration by a flat retinal preparation. Am J Ophthalmol, 1956; 41: 1–2.
Burton TC : Unilateral Purtscher's retinopathy. Ophthalmology, 1980; 87: 1096–1105.
Archer DB, Earley OE, Page AB, Johnston PB : Retinal vascular alterations following head injury. Proceedings of the Retina Workshop Florence, Italy, May 1986; pp 105–112.
Archer DB and Gardiner TA : Experimental inner retinal ischaemia and the blood retinal barriers. In The Blood Retinal Barriers. Ed JG Cunha-Vaz. Plenum Pub; pp 279–99.
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Archer, D., Earley, O., Page, A. et al. Traumatic retinal angiopathy - associated with wearing of car seat belts. Eye 2, 650–659 (1988). https://doi.org/10.1038/eye.1988.120
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DOI: https://doi.org/10.1038/eye.1988.120
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