Respirator retina

R. Y. Foos and R. H. Rhodes

Retinas from 14 comatose patients, who had been sustained with a respirator for one or more days before death, had selective characteristic alterations (ie, autophagy, cell swelling, and coagulation necrosis) of inner nuclear layer in a patchy pattern in posterior fundus. Bipolar cells were most often affected, but amacrine and horizontal cells also were substantially damaged. Cells of Muller and vascular cells were largely spared. These lesions are ascribed to oligemia (ischemia) since the inner nuclear layer is a microscopic vascular watershed (boundary zone) between the choroidal and retinal circulations.