CASE REPORT
A 15-year-old girl with a traumatic ocular injury after being hit in the eye by an elbow was evaluated. Upon the first examination, the best-corrected visual acuity was 16/20.
The findings were subretinal pigment epithelial hemorrhage and vertical choroidal rupture.
Three weeks after the trauma, the patient’s visual acuity was reduced to counting fingers at 30 cm.
On fundus examination and fluorescein angiography, subretinal pigment epithelial hemorrhage decreased, while the choroidal rupture expanded; on optical coherence tomography, outer retinal changes in the adjacent area were detected.
DISEASE
A choroidal rupture is a break in the choroid, Bruch membrane, and retinal pigment epithelium (RPE).
A choroidal rupture occurs as a result of the traumatic mechanical event directly at the site of contusion or more commonly away from the impact.
The force buckles the globe in at the area of impact and causes globe wall stress folding at a peripheral site causing the choroid, RPE, and Bruch membrane complex to stretch and break.
MANAGEMENT
Observation is recommended. An Amsler grid may be given to the patient and any changes in the grid should be reported to the patient’s eye care provider since a change may indicate the development of CNV.
However,
in the presence of CNV, anti-vascular endothelial growth factor injections can be used.
There is no medical therapy available to cause the resolution of a choroidal rupture.
Complications
Subretinal and subRPE hemorrhage can result at the time the choroidal rupture develops.
Choroidal neovascularization, usually type 2, can develop from the choroidal rupture where choroidal neovessels proliferate and grow in the subretinal space, leading to hemorrhage and fibrosis, and decreased vision if untreated.
Most CNV undergoes spontaneous resolution but many will need an anti-VEGF injection.
Would you have interest in taking retina images by smartphone?
Fundus photography is superior to fundus analysis as it enables intraocular pathologies to be photo captured and encrypted information to be shared with colleagues and patients.
Recent technologies allow smartphone-based attachments and integrated lens adaptors to transform the smartphone into a portable fundus camera and Retinal imaging by smartphone.
RETINAL IMAGING BY YOUR SMARTPHONE
RETINAL IMAGING BY YOUR SMARTPHONE
