Nair Unnikrishnan, Soman Manoj, Ganekal Sunil, Batmanabane Vaishnavi, Nair Kgr
Chaithanya Eye Hospital and Research Institute, Trivandrum, Kerala.
Clin Ophthalmol. 2013;7:1503-9. doi: 10.2147/OPTH.S46223. Epub 2013 Jul 22.
To evaluate the morphological types of indirect choroidal rupture (ICR) using spectral domain optical coherence tomography (SD-OCT).
This was a prospective interventional study of 18 eyes of 18 patients who presented with a history of blunt ocular trauma resulting in choroidal rupture. All patients underwent detailed ophthalmic evaluation and SD-OCT examination.
Mean age of the patients was 32±9.6 years. Morphologically, two types of choroidal rupture were seen on SD-OCT. The first type seen (Type 1 ICR) was a forward protrusion of the retinal pigment epithelium-choriocapillaris (RPE-CC) layer with an acutely angled pyramid or dome shape. This was associated with either a small loss of continuity of the retinal pigment epithelium layer or elevated RPE-CC projection accompanied by a significant quantity of subretinal hemorrhage. The second type observed (Type 2 ICR) was a larger area of disruption of the RPE-CC layer, photoreceptor inner segment/outer segment junction, and external limiting membrane, with a posteriorly directed concave contour depression at that area and downward sliding of tissues into the defect. At presentation, ten eyes were observed to have Type 1 ICR and eight to have Type 2 ICR. Of the 18 eyes, one with Type 1 ICR and two with Type 2 ICR developed choroidal neovascularization (16.6%).
Two distinct tomographic patterns of choroidal ruptures were identified on SD-OCT, which may allow ruptures to be classified into two morphological types. There are morphometric and clinical differences between the two types, which may help to prognosticate visual outcome and anticipate complications following choroidal ruptures.
利用频域光学相干断层扫描（SD - OCT）评估间接性脉络膜破裂（ICR）的形态学类型。
这是一项对18例因钝性眼外伤导致脉络膜破裂患者的18只眼进行的前瞻性干预研究。所有患者均接受了详细的眼科评估和SD - OCT检查。
患者的平均年龄为32±9.6岁。在SD - OCT上可见两种形态学类型的脉络膜破裂。第一种类型（1型ICR）是视网膜色素上皮 - 脉络膜毛细血管（RPE - CC）层向前突出，呈锐角金字塔形或穹顶形。这与视网膜色素上皮层的小范围连续性丧失或RPE - CC突出伴大量视网膜下出血有关。观察到的第二种类型（2型ICR）是RPE - CC层、光感受器内节/外节连接和外界膜的更大范围破坏，该区域有向后的凹形轮廓凹陷以及组织向缺损处下滑。就诊时，观察到10只眼为1型ICR，8只眼为2型ICR。在这18只眼中，1只1型ICR眼和2只2型ICR眼发生了脉络膜新生血管（16.6%）。
在SD - OCT上识别出了两种不同的脉络膜破裂断层图像模式，这可能使破裂可被分为两种形态学类型。这两种类型在形态测量和临床方面存在差异，这可能有助于预测脉络膜破裂后的视力预后并预判并发症。
