WHIPLASH MACULOPATHY: STRUCTURAL SEQUELAE AND THE CORRESPONDING VISUAL IMPAIRMENT, DOCUMENTED WITH OPTICAL COHERENCE TOMOGRAPHY.

Purpose: To explore the natural history of whiplash maculopathy through a clinical case report, emphasizing the role of optical coherence tomography (OCT) in diagnosing and understanding this ocular condition.

Methods: A 55-year-old woman presented to the Emergency Service after a head-on collision, reporting decreased visual acuity (VA) in her left eye. VA was 20/20 in the right eye and 20/40 in the left. Funduscopic examination revealed subtle retinal pigment epithelium (RPE) disruption, and OCT showed neurosensory detachment (NSD) with intraretinal cysts.

Results: One week later, OCT indicated a slightly unstructured RPE, with no NSD or cysts. Fluorescein angiography was normal, and VA improved to 20/25. A central scotoma was noted in visual field (VF) testing 10 days post-accident. Although VA and OCT nearly normalized two months later, infrared imaging (IR) revealed a hypo-reflective macular area correlating with VF defects. Eight years later, the patient continues exhibiting a persistent central scotoma and subtle outer retinal irregularity on OCT.

Conclusions: Whiplash maculopathy, a form of indirect ocular trauma, typically results in temporary visual impairment and central scotoma. Its natural history includes spontaneous improvement, with changes likely arising from vitreoretinal traction forces. This case underscores the long-term retinal changes associated with whiplash injuries.