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Presentation typeE-poster
TitleFulminant choroidal neovascularization following Bruch’s membrane rupture in closed-globe trauma : A case report.
PurposeThe aim of this case report is to highlight the diagnosis process assisted by multimodal analysis in a case of early onset choroidal neovascularization (CNV) in a 20 year-old male patient with severe unilateral closed globe trauma (CGT).
MethodsOcular multimodal analysis, including Optical Coherence Tomography (OCT), Optical Coherence Angiography (OCT-A), fundus photography, fundus autofluorescence and fluorescein angiography (FA) was performed to evaluate retinal and choroidal complications of the CGT, therapeutical options and close follow-up for the patient.
ResultsFundus photography revealed large subretinal hemorrhages and numerous well-defined arciform choroidal ruptures, one of which being foveolar. Autofluorescence showed hypoautofluorescence at the level of RPE breaks. OCT exhibited large abrupt interruptions of Bruch’s membrane and an elevation of the retina at the peripapillary and retrofoveolar haematomas. Eight days after the trauma, OCT-A revealed a polyarborized neovascular structure in the avascular zone, corresponding to a type II foveolar CNV while FA displayed a central hyperfluoresence by “window effect” with poor diffusion. After multiple anti-VEGF intravitreal injections, the VA improved significantly to 1,0 whereas the CNV regressed.
ConclusionClosed globe trauma is a dreadful event because of direct damage to the delicate ocular anatomy but also by possible delayed ocular damages. One of the delayed complications of CGT is CNV following choroidal rupture. To our knowledge, this case is the first to report such unexpectedly early case of active CNV within 8 days. No consensus has been reached but anti-VEGF intravitreal injections seem to be efficient when CNV is present.
Conflict of interestNo
Details of conflicting interestsNihil
Authors 1
Last nameHAULOT
InitialsT
DepartmentCliniques universitaires Saint-Luc
CityWoluwe
Authors 2
Last nameGUAGNINI
InitialsA-P
DepartmentCliniques universitaires Saint-Luc
CityWoluwe
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