Late Macular Complications of Choroidal Ruptures

Abstract

Late complications of ocular contusion have been widely studied. Attention is fre­ quently directed to the anterior segment, to late onset glaucoma and its relation to angle recession. Posteriorly, late onset of retinal detachment is well recognized. Recently de­ layed damage to the macula related to ad­ jacent choroidal ruptures causing late visual symptoms has been recognized by Gass' and Fuller and Gitter. Choroidal rupture is a common complica­ tion of contusion injuries of the eye. Such rents in the choroid (and in Bruch's mem­ brane) usually occur temporal to the disk in a concentric fashion and are often associ­ ated with intrachoroidal, subretinal, and intraretinal hemorrhage. The usual course of such injuries is one of gradual clearing of localized hemorrhage and retinal or choroidal edema with formation of a gliotic scar and pigment epithelial alterations in the area of the choroid tear. If the macula has not been directly involved, good visual acuity is to be expected. Usually the area remains essentially unchanged. Gass and others,' however, have observed hemorrhagic detachment of the pigment epi­ thelium as a late complication of choroidal rupture. Fuller and Gitter described a case in which subretinal neovascularization and serous detachment of the macula occurred six months after choroidal rupture. Patients with choroidal rupture should be followed with the potential complication in mind. Fluorescein angiography is useful in detecting and observing the changes in the choroidal rupture. Our report concerns three additional cases