Case of the Month I December 2019

Case of the Month
December 23, 2019

The Case

The patient was a 50-year-old man without visual complaints who was referred for a possible retinal tear. His past medical history was unremarkable. His past ocular history was remarkable for being hit in the right eye when he was an adolescent by a fist or elbow as an accident while sledding. He had blurred vision in that eye that resolved. The photo is centered at the temporal macula. What is the most likely diagnosis? What treatment, if any, would you recommend?

The patient had a choroidal rupture related to the ocular trauma, which led to a choroidal neovascular membrane that underwent fibrotic involution. The preretinal fibrosis is unusual and indicates a retinal break that released pluripotential cells that underwent metaplasia into fibrotic tissue. The retinal break evidently occurred at the same site as the choroidal rupture. Otherwise, the preretinal fibrosis would have been more likely to manifest as a thin sheet over the inferior retina or the macula. In this case, what evidently occurred is that there was a choroidal neovascular membrane associated with the choroidal rupture that grew through a break in the retina and into the preretinal space.

Case Photos

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The patient had a choroidal rupture related to the ocular trauma, which led to a choroidal neovascular membrane that underwent fibrotic involution. The preretinal fibrosis is unusual and indicates a retinal break that released pluripotential cells that underwent metaplasia into fibrotic tissue. The retinal break evidently occurred at the same site as the choroidal rupture. Otherwise, the preretinal fibrosis would have been more likely to manifest as a thin sheet over the inferior retina or the macula. In this case, what evidently occurred is that there was a choroidal neovascular membrane associated with the choroidal rupture that grew through a break in the retina and into the preretinal space.

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