Adhi Mehreen, Reinoso Maria
Department of Ophthalmology and Visual Sciences, 12258Louisiana State University, New Orleans, LA, USA.
Eur J Ophthalmol. 2021 Nov 17:11206721211059030. doi: 10.1177/11206721211059030.
Choroidal rupture is a tear/break within the Bruch's membrane, retinal pigment epithelium and choroid following blunt trauma. Choroidal neovascularization is a well-known complication of traumatic choroidal rupture that is typically treated with intravitreal injections of Bevacizumab. This case describes an early detection of choroidal neovascular complex secondary to traumatic choroidal rupture and its spontaneous regression and quiescence without treatment followed using optical coherence tomography (OCT) angiography.
A healthy 19 year old female presented with decreased vision in her left eye following a blunt non-penetrating closed globe injury two weeks prior. A complete ophthalmic examination with ancillary testing was consistent with sub-foveal choroidal neovascularization secondary to traumatic choroidal rupture. Five weeks later, there was spontaneous regression of the choroidal neovascular complex as depicted on OCT angiography and complete resolution of subretinal fluid/exudation on structural OCT. A conservative approach without intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections was chosen for management.
To the authors' knowledge this is a first case describing a unique evolution with spontaneous regression and quiescence of choroidal neovascularization secondary to traumatic choroidal rupture without treatment followed using OCT angiography. Expectant management may be a viable treatment option for this condition.
脉络膜破裂是钝性外伤后发生于 Bruch 膜、视网膜色素上皮和脉络膜的撕裂/断裂。脉络膜新生血管形成是外伤性脉络膜破裂的一种众所周知的并发症,通常采用玻璃体内注射贝伐单抗进行治疗。本病例描述了一例继发于外伤性脉络膜破裂的脉络膜新生血管复合体的早期发现,以及在未进行治疗的情况下其自发消退和静止的过程,并通过光学相干断层扫描(OCT)血管造影进行了随访。
一名 19 岁健康女性在两周前遭受钝性非穿透性眼球闭合伤后出现左眼视力下降。全面的眼科检查及辅助检查结果与外伤性脉络膜破裂继发的黄斑下脉络膜新生血管形成相符。五周后,OCT 血管造影显示脉络膜新生血管复合体自发消退,结构 OCT 显示视网膜下液/渗出完全吸收。治疗选择了不进行玻璃体内抗血管内皮生长因子(抗 VEGF)注射的保守方法。
据作者所知,这是首例描述继发于外伤性脉络膜破裂的脉络膜新生血管形成在未治疗情况下自发消退和静止的独特演变过程,并通过 OCT 血管造影进行随访的病例。期待性处理可能是这种情况的一种可行治疗选择。