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JAMA Ophthalmology Clinical Challenge
December 27, 2018

Central Scotoma a Year After Motor Vehicle Crash

Author Affiliations
  • 1Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts
  • 2National and Kapodistrian University Athens Medical School, Athens, Greece
JAMA Ophthalmol. 2019;137(3):316-317. doi:10.1001/jamaophthalmol.2018.5421

A woman in her early 60s presented with an 8-month history of central scotoma and blurry vision in her right eye. Her medical history was significant for a motor vehicle crash that occurred almost a year earlier, with no direct head trauma or eye injury. On examination, her best-corrected visual acuity was 20/500 OD and 20/30 OS. Anterior segment examination was remarkable for pseudophakia on the right eye and mild cataract in the left. Fundus examination was remarkable for a slightly blunted foveal reflex in the right eye. Spectral-domain optical coherence tomography (SD-OCT) showed segmental atrophy of the inner retina (Figure 1A). Fluorescein angiography was unrevealing (Figure 1B).

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