Retinal Tear Formation After WholeBody Vibration WBV Training Exercise

Mei-Chuan Yu

Abstract

Purpose: The purpose of this report is to describe the occurrence of a retinal tear, pre-retinal and vitreous hemorrhages after a session of WBV training. Case Report: A 59-year-old male presented with a chief complaint of floaters and a moving shadow OS within a few hours of completing a session of WBV training. A temporal retinal tear, 1+ vitreous hemorrhage, and pre-retinal hemorrhage was found OS. His vision was 20/30 OD and 20/30-2 OS. His health history was positive for hyperlipidemia, hypertension, and DMII without ocular manifestations. The retinal tear was treated using laser photocoagulation. At the 4-month follow up there was resolution of the vitreous and pre-retinal hemorrhage with no new tears seen.
Vibration and shaking have been shown to have effects on various tissues in the human body 1. Vibration can be caused by occupational environment (e.g. pneumatic drill operation), trauma (e.g. shaken baby syndrome), and WBV training exercise. Some documented findings of adverse vibration after-effects include vasospastic diseases in hands 2 as well as ocular effects such as increased pigment within the trabecular meshwork, vitreous liquefaction 3 and retinal and vitreous bleeding in child abuse 4. In current literature, there has only been two documented cases of vitreous hemorrhage following WBV exercise 5,6. Both of these papers suggest a high probability of correlation between WBV training and subsequent vitreous hemorrhage.
Our patient had utilized a WBV training device for 60 seconds a few hours before the onset of his ocular symptoms. The device used by our patient included a footplate on which the user can position him or herself that vibrates at a frequency up to 25-50 Hz. One study details how mechanical resonant frequency can affect the eye, outlining different vibration frequencies between 5 to 50 Hz with secondary transmission frequency to the eye 7. This study suggests the approximate resonant frequency of the eye to be 18 Hz and a partial resonance of 10-12 Hz for the vitreous body 7.

Conclusion: One possible pathogenesis of the retinal tear and vitreous hemorrhage was instigated by the vibrations from the machine transmitting a vibratory force to the eye and vitreous. In various types of vitreous-induced retinal tear formation, it is thought that vitreous movement causes shear injury to the retina at the vitreous base. The tear in our patient occurred at the vitreous base. The vibratory force probably caused his retinal tear and vitreous hemorrhage since the onset of symptoms was within 24 hours of using the WBV training device. We believe our patient and those in the Bertschinger and Gillan papers strongly suggest that high-force vibration training may cause retinal tears in susceptible persons. Though our patient is the third documented case of vitreous hemorrhage following WBV training, he is the first to show a close association of a retinal tear and vitreous hemorrhage with WBV training.

Details

Year: 2018

Program Number: 185386

Resource Type: Scientific Program

Author Affiliation: Orange County Retina Medical Group

Co-Authors: n/a

Co-Author Affiliation: n/a

Room: Exhibit Hall 3