Choroidal neovascularization in a patient with blunt trauma-caused traumatic retinopathy without choroidal rupture

Graefes Arch Clin Exp Ophthalmol. 2011 Jan;249(1):137-40. doi: 10.1007/s00417-010-1472-0. Epub 2010 Aug 17.

Abstract

Purpose: To report a case of choroidal neovascularization (CNV) following blunt trauma without choroidal rupture, with past history of central serous chorioretinopathy (CSC).

Methods: 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.

Conclusion: 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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Angiogenesis Inhibitors / administration & dosage
  • Antibodies, Monoclonal / administration & dosage
  • Antibodies, Monoclonal, Humanized
  • Baseball / injuries*
  • Bevacizumab
  • Central Serous Chorioretinopathy / drug therapy
  • Central Serous Chorioretinopathy / etiology*
  • Choroid / injuries
  • Choroidal Neovascularization / drug therapy
  • Choroidal Neovascularization / etiology*
  • Eye Injuries / etiology*
  • Fluorescein Angiography
  • Humans
  • Intravitreal Injections
  • Male
  • Rupture
  • Tomography, Optical Coherence
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Wounds, Nonpenetrating / etiology*

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Bevacizumab