Closed globe Trauma (CGT) is a frequent cause of loss of uniocular vision, especially in young men, due to vehicular accidents or during work, as well as sports 1.

The presence of hyphema has been described as well as retinal tears and choroid rupture 2. Also, microhyphema or traumatic iritis reported on approximately 81.6% of patients. As well as extrafoveal choroidal rupture, extrafoveal subretinal hemorrhage and mild vitreous hemorrhage. 3

The first hypothesis of Berlin (1873) was that the findings of the fundoscopic examination were due to the extracellular retinal edema 4. Commotio retinae is a frequent cause of ophthalmological emergency following CGT, mostly due to sport, but to traffic or work accidents. There is no specific treatment, but clinicians usually treat anterior and posterior segments-associated injuries 5.

The reported findings of the histologic examinations were identifying photoreceptor and retinal pigment epithelium (RPE) layers to be the major site of injury 6. When the macular region is affected by a closed eye trauma, vision is significantly affected; especially when Bruch's membrane is damaged, because the scarring of this membrane distorts the anatomy of the area (choriocapillaris, pigmented epithelium, photoreceptors) (Figure 1).

In this work we present a case of closed ocular trauma, with Berlin edema, which was treated with ǪIAPI ®, to restore the balance in the generation of oxygen at the intracellular level, and the results, in terms of visual acuity, were excellent, given the proximity of the choroid ruptures to the foveolar umbo

PATIENT NAME: D. A. V. M.

DATE OF BIRTH: 09/Apr/1997 TODAY'S DATE: 18/Jan/25 GENDER: Male.

Phototype V. Yesterday, an accident at work, heavy machinery, the machine threw a stone and fell it in the right eye. In a private hospital they treated him, they proposed surgery, they prescribed him: Ketorolac, serrati peptidase, and Vigamoxi eye drops. (Figure 2, Figure 3, Figure 4, Figure 5, Figure 6, Figure 7, Figure 8, Figure 9, Figure 10, Figure 11, Figure 12).

SpO2%: 89 %

Heart beat: 65 x´

Sciascopy: ++/++

Figure 12. The photograph of the back of the eye, on the left side, shows a normal anatomy.

February 1, 2025

During the second consultation, carried out on 02/01/2025, the following photographs were taken (Figure 13, Figure 14, Figure 15, Figure 16, Figure 17, Figure 18, Figure 19)

SpO2 %: 87 %

Heart rate: 74 x ́

Sciascopy: ++/++

February 22, 2025

There is no pain, only minimal discomfort, and my vision has improved (Figure 20, Figure 21, Figure 22, Figure 23, Figure 24)

SpO2 %: 91 %

Heartbeat: 67 x´

Sciascopy: ++/++

March 15 2025

Feels fine, better, occasional headache (Figure 25, Figure 26, Figure 27, Figure 28, Figure 29, Figure 30)

SpO2%: 89%,

heart rate 68 x´,

Sciascopy: +/+.

August 26, 2025

It's been fine, there's only a little veil that prevents it from seeing well completely, although it's very transparent (Figure 31, Figure 32, Figure 33, Figure 34, Figure 35, Figure 36).

94 %

62 x ́

++/++

Despite being a patient affected in the macular region by the blunt trauma he suffered at work, the recovery was very satisfactory, which is not easy to achieve with established orthodox treatments, including surgery and powerful anti- inflammatories.

Commotio retinae with foveal involvement, also known as Berlin´s Edema 7, It is a common cause of monocular vision loss, especially in young male adults. The prognosis is uncertain depending on variables such as location of the affected area, severity of the damage that occurred, extent of the bleeding, vision at the beginning of treatment, etc. There is no single or optimal treatment as it depends on the conditions at the beginning of treatment.

The purpose of publishing this case is to demonstrate the benefits of a new therapeutic approach based on the unsuspected ability of human cells to produce their own oxygen 8, which breaks into a thousand pieces the old dogma, widely spread, that our body took the oxygen it requires for its metabolism from the air that surrounds it.