Husain Alina, Winebrake James P, Goldberg Naomi R, Mahrous M Abdallah, Kovacs Kyle D
Department of Ophthalmology, and MD Program, Weill Cornell Medicine, New York, NY, USA.
Department of Ophthalmology, Weill Cornell Medicine, New York, NY, USA.
J Vitreoretin Dis. 2025 Jan 30:24741264251315157. doi: 10.1177/24741264251315157.
To describe a patient with a traumatic choroidal rupture and a submacular hemorrhage, the course of which was complicated by delayed-onset posterior uveitis resembling a white-dot syndrome.
A single case was evaluated.
A 34-year-old man presented after being struck in the left eye with a tennis ball. The visual acuity (VA) was 20/30 with otherwise normal ophthalmic vitals. An examination showed traumatic iritis and choroidal rupture with a submacular hemorrhage without subfoveal involvement. Despite treatment of anterior segment inflammation and a worsening hemorrhage with topical agents and intravitreal aflibercept, the VA decreased to 20/600. A repeat examination with optical coherence tomography showed new optic disc edema, placoid outer retinal lesions adjacent to the choroidal rupture, and corresponding ellipsoid zone atrophy. A broad workup was unremarkable, and the patient completed a long taper of high-dose oral prednisone without recurrence.
Traumatic exposure of the immunologically privileged subretinal space to high-flow choroidal circulation likely triggered a pathway involving self-autoantigenicity and a uveitic response.
描述一名患有外伤性脉络膜破裂和黄斑下出血的患者，其病程因类似于白点综合征的迟发性后葡萄膜炎而复杂化。
对单一病例进行评估。
一名34岁男性在左眼被网球击中后就诊。视力（VA）为20/30，眼科生命体征其他方面正常。检查显示外伤性虹膜炎和脉络膜破裂伴黄斑下出血，不累及黄斑中心凹。尽管使用局部药物和玻璃体内阿柏西普治疗前段炎症和出血恶化，但视力降至20/600。光学相干断层扫描复查显示新的视盘水肿、脉络膜破裂附近的扁平状外层视网膜病变以及相应的椭圆体带萎缩。广泛检查无异常，患者完成了大剂量口服泼尼松的长疗程减量且无复发。
免疫赦免的视网膜下间隙在外伤情况下暴露于高流量脉络膜循环，可能触发了一条涉及自身自身抗原性和葡萄膜炎反应的途径。
