Successful closure of large blunt macular chorioretinal rupture: a case report

Abstract

Daisuke Muramatsu1, Takuya Iwasaki2, Tsuyoshi Agawa1, Masahiko Usui1, Hiroshi Goto11Department of Ophthalmology, Tokyo Medical University, 2Department of Ophthalmology, Tokyo Medical University Ibaraki Medical Center, Tokyo, JapanAbstract: The authors present a rare case of large chorioretinal rupture caused by blunt traumatic injury of the globe. A 22-year-old woman sustained a blunt injury to her left eye. The best-corrected Snellen visual acuity was 2/20 in her left eye, and hyphema and vitreous hemorrhage were noted. The day after the injury occurred the vitreous hemorrhage had disappeared. Fundus examination revealed a crescent-shaped retinal rupture three disc diameters in size near the macula, and a choroidal rupture six disc diameters in size that was over the vascular arcade. Three days after the injury, vitrectomy with internal limiting membrane peeling was performed. Postoperative prone positioning was maintained for 4 days. Five days postoperatively, closure of the ruptured retina was confirmed. The visual acuity improved to 16/20 4 months after surgery and this was maintained over a 48-month period. In conclusion, early vitrectomy with internal limiting membrane peeling after injury was effective for a case involving severe blunt chorioretinal rupture with closed globe injury.Keywords: choroidal rupture, retinal rupture, traumatic macular hole, closed globe injury, internal limiting membrane