ABSTRACT
@#AIM: To investigate the diagnostic value of optical coherence tomography angiography(OCTA)in choroidal rupture and evaluate the imaging features. <p>METHODS: We selected 25 patients(25 eyes)whom were diagnosed as choroidal rupturein in this retrospective observational case. All patients underwent fundus photography, fundus fluorescein angiography(FFA), indocyannine green angiograph(ICGA), spectral domain optical coherence tomography(SD-OCT)and OCTA examinations.<p>RESULTS: All the patients showed the lesions were mostly located in the macular area or on the temporal side of the optic disc, with a yellow-white arc hyperreflexia with stripes shape, it can be accompanied by retinal choroidal edema and subretinal hemorrhage. In the early stage of FFA, it showed a curved shape window defect of choroidal rupture, and fluorescent staining in the late stage. When secondary to choroidal neovascularization(CNV), the active CNV showed a hyperfluorescence leakage. SD-OCT showed the reflex of outer retina and choroidal capillary layer were ruptured, the reflex of the surrounding tissue were reinforced, the subretinal small cluster hyperreflexia can be seen. The granulation tissue showed an arc hyperreflexia with “stripe shape” in the outer retinal and choroid capillary layer of OCTA angiogram image. On the B-scan, it showed an inwardly bulge or outwardly recess shap, with blood flow signal inside. When secondary to CNV, vascular morphology can be seen clearly, most of them were cluster shape, which is different from the granulation tissue.<p>CONCLUSION: Although the granulation tissue and CNV of choroid rupture showed cluster shap and blood flow signal on OCTA, there were significant differences in morphology and tissue composition between them. Through the display of OCTA stratification and the detailed observation of the lesion, the diagnosis rate of secondary CNV in choroidal rupture can be improved.
ABSTRACT
Objetivo: describir el seguimiento clínico por 24 años de una ruptura coroidea y su neovascularización coroidea secundaria a trauma ocular cerrado. Efectuar una revisión bibliográfica de esta patología. Destacar la importancia de observaciones prolongadas para completar su historia natural. Diseño: reporte de caso no intervencionista. Método: retrospectivo, en caso de trauma ocular cerrado y sus consecuencias estudiadas en seguimiento cuidadoso de 24 años y la ayuda diagnóstica de la tomografía óptica coherente, la fluoroangiografía y el campo visual. Resultado: reconocimiento de glaucoma y catarata que disminuyeron la visión a 20/120 veinticuatro años después de la contusión ocular. Conclusión: La neovascularizacion coroidea secundaria a ruptura coroidea traumática subfoveal aparece en tiempo variable luego de trauma ocular contuso, compromete la recuperación anatómica y visual, y es de pronóstico reservado de acuerdo con su localización según hallazgos en observación prolongada.
Purpose: to describe findings and follow-up for 24 years in a choroidal rupture with secondary choroidal neovascularization following closed ocular trauma. To perform a literature review on this topic. To remark the importance of long follow-up to complete natural history of disease. Design: non-interventional case report. Methods: retrospective, in a case ofbclosed ocular trauma and sequels on a follow-up of 24 years using optical coherence tomography and fl uorescein angiography as diagnostic techniques. Results: recognition of glaucoma, cataract and decreased visual acuity to 20/120. Conclusion: choroidal neovascularization following indirect subfoveal traumatic choroidal rupture may occur in variable time after blunt trauma, affecting ocular structures and visual function with poor prognosis demonstrated on long follow-up.
Subject(s)
Eye Injuries/diagnosis , Eye Diseases/diagnosis , Eye Injuries, Penetrating/diagnosisABSTRACT
PURPOSE: We report a case of a full-thickness macular hole which occurred many years after a blunt eye trauma leading to choroidal rupture. CASE SUMMARY: A 50-year-old male visited our clinic with a complaint of decreased vision in his left eye 2 years in duration. He experienced a blunt trauma to his left eye with a baseball when he was 6 years old, although he did not complain of any visual disturbance in the left eye at that time. Fundus examination revealed a full-thickness macular hole with vertical fibrotic scar at the temporal side of the macula, which was thought to be a choroidal rupture induced by the previous blunt eye trauma. We performed vitrectomy and intravitreal tamponade injection. Two months later, the full-thickness macular hole completely closed and visual acuity of the left eye improved.
Subject(s)
Humans , Male , Middle Aged , Baseball , Choroid , Cicatrix , Retinal Perforations , Rupture , Visual Acuity , VitrectomyABSTRACT
PURPOSE: To report a case of bilateral chorioretinal injury by needleless jet injector misuse. CASE SUMMARY: In a dermatology department, the patient was diagnosed as having total alopecia and was scheduled to be injected on her eyelash by needleless jet injector for treatment but inexpert doctor injected on the eyelid, not eyelash, by mistake. She then suddenly complained of blurred vision and a floater just after that procedure and was referred to the ophthalmology department. Bilateral vitreous hemorrhage and preretinal hemorrhage were seen during indirect ophthalmoscopic examination and bilateral prophylactic argon laser photocoagulation was done around the suspicious tear site. Then bilateral vitreous hemorrhage and preretinal hemorrhage were absorbed and we found a partial retinal rupture lesion and choroidal rupture lesion in the right eye and a retinal injury lesion in the lefteye. Therefore we observed the lesions of both eyes continuously without further treatment. Her clinical symptoms improved. CONCLUSIONS: Needleless jet injector has many advantages, especially less pain and injury than a normal needle injector and is usually used in clinic as preoperative local anesthesia and steroid injection in many medical fields. In this case, the needleless injector was accidentally misused inducing both direct and indirect choroidal rupture and retinal injury. In general, while a needleless jet injector is used in ophthalmology department, we have to use it with the greatest care.
Subject(s)
Humans , Alopecia , Anesthesia, Local , Argon , Choroid , Dermatology , Eye , Eyelids , Hemorrhage , Light Coagulation , Needles , Ophthalmology , Retinaldehyde , Rupture , Vision, Ocular , Vitreous HemorrhageABSTRACT
With the increasing number of air bag-equipped vehicles, there has been a corresponding increase in the incidence of air bag-associated ocular trauma. We encountered a 38 years old man who sustained corneal damage, hyphema, angle recession, medial wall fracture, and visual damage by choroidal rupture of macula due to an inflated air bag in motor vehicle accident and brief review of related literature is presented.