Department of Ophthalmology, Teine Keijinkai Hospital, Sapporo, Japan.
Graefes Arch Clin Exp Ophthalmol. 2011 Jan;249(1):137-40. doi: 10.1007/s00417-010-1472-0. Epub 2010 Aug 17.
To report a case of choroidal neovascularization (CNV) following blunt trauma without choroidal rupture, with past history of central serous chorioretinopathy (CSC).
A 43-year-old man with a nonperforating injury caused by a baseball that hit his right eye exhibited traumatic retinopathy. The damage was localized to the outer layer of the retina at the macula and there was no choroidal rupture. Five years prior to the accident, the patient suffered from a CSC attack with retinal pigment epithelium detachment. Two weeks after the blunt trauma, fundus examination revealed CNV extending into the subfoveal space, which led to an abrupt development of retinal hemorrhage and serous retinal detachment at the macula. Intravitreal injection of bevacizumab led to the resolution of retinal detachment 15 days later, with complete absorption of retinal hemorrhage 41 days later. Fluorescein angiography performed 2 months later revealed hyperfluorescent points with no leakage.
CNV following blunt trauma in this case occurred in traumatic retinopathy, with the damage localized in the outer layer of the retina. This suggests that the retinal pigment epithelium-Bruch's membrane complex developed susceptibility to anteroposterior forces, which is subsequent to the spontaneous healing of CSC. Bevacizumab treatment also reduced exudation from CNV.
报告 1 例既往有中心性浆液性脉络膜视网膜病变（CSC）病史、钝挫伤后发生脉络膜新生血管（CNV）但无脉络膜破裂的病例。
1 名 43 岁男性右眼被棒球击中，造成非穿透性损伤，表现为外伤性视网膜病变。损伤局限于黄斑部视网膜外层，无脉络膜破裂。在此次外伤前 5 年，患者曾发生过 CSC 发作，伴视网膜色素上皮脱离。钝挫伤后 2 周，眼底检查发现 CNV 延伸至黄斑下，导致黄斑区视网膜突然出血和浆液性视网膜脱离。玻璃体内注射贝伐单抗 15 天后视网膜脱离得到解决，41 天后视网膜出血完全吸收。2 个月后行荧光素眼底血管造影检查显示高荧光点，无渗漏。
本例钝挫伤后 CNV 发生于外伤性视网膜病变，损伤局限于视网膜外层。这表明，在 CSC 自发愈合后，视网膜色素上皮 - 脉络膜毛细血管复合体对外力的易感性增加。贝伐单抗治疗也减少了 CNV 的渗出。
