Choroidal Rupture

Abstract

First described in 1854 by von Graefe, 1 a choroidal rupture is a break in the choroid, the Bruch membrane, and retinal pigment epithelium (RPE). Here, we review the causes, pathophysiological basis, clinical and imaging findings, complications, prognosis, and treatments for choroidal ruptures. ' CausesChoroidal ruptures have been reported in up to 5% to 10% of cases of blunt ocular trauma but can also occur in the setting of penetrating or perforating injuries. [2][3][4] In one study of 111 cases of choroidal rupture presenting at a single institution, 28% were due to open globe injuries, whereas 72% were due to closed globe injuries. 3 Patients with angioid streaks are at particularly high risk of choroidal rupture after trauma, owing to the brittle nature of their Bruch membrane. 5 Virtually any form of traumatic injury to the eye can result in choroidal ruptures. Sports injuries predominate in the literature, including injuries occurring during karate, 6 or caused by various sports equipment including a hockey puck, 7 soccer ball, 8 cricket ball, 9 basketball, 9 tennis ball, 10,11 golf ball, 12 baseball, 13 or paint ball.

Optical coherence tomography angiography-guided diagnosis of a traumatic choroidal rupture-associated choroidal neovasular membrane and its management with intravitreal ranibizumab

“…CR has been reported in 5%–10% of cases of blunt ocular trauma. [ 5 ] It may occur directly at the site of impact or more commonly at a site distant from the place of injury due to countercoup mechanism. [ 5 ] Various hypotheses have been postulated to explain the genesis of CR.…”

“…[ 5 ] It may occur directly at the site of impact or more commonly at a site distant from the place of injury due to countercoup mechanism. [ 5 ] Various hypotheses have been postulated to explain the genesis of CR. Sudden anteroposterior deformation of the globe following trauma with subsequent equatorial expansion has been incriminated for CR.…”

“…Risk of CNVM has been increasingly associated with length of CR, age, and location within the arcades. [ 5 ] Loss of mechanical and chemical barrier due to interruption in the RPE-BM complex and VEGF upregulation secondary to increased release of elasin-derived peptides from damaged elastic lamina of BM, have been incriminated in pathophysiology of CR associated CNVM. [ 8 ] Abundance of perfusion from the choroidal vasculature and more intense wound-healing process predispose the macular region further to increased propensity to CNVM formation.…”

Novel Suturing Methods for the Management of Traumatic Choroidal Avulsion in Globe Injuries

“…It was reported that choroidal injuries were observed in 69.7% of all the eyes with no light perception and were estimated as a predictor of poor prognosis (3). Traumatic choroidal injuries are not uncommon in clinical practice, and a variety of choroidal injuries have been reported (4)(5)(6)(7). In our recent study (8), we summarized traumatic choroidal injuries into nine categories, including suprachoroidal effusion, suprachoroidal hemorrhage, massive suprachoroidal hemorrhage, choroidal avulsion, traumatic chorioretinal rupture, choroidal rupture, choroidal loss, choroidal hole, and choroidal damage at the wound site, and a classification system for traumatic choroidal injuries was proposed.…”

Optical Coherence Tomography Angiography Imaging of Choroidal Neovascularization Secondary to Choroidal Rupture Treated by Intravitreal Ranibizumab

“…Classically, we distinguish two types of globe injuries: open and closed (indirect tissue damage), which could be complicated by a CR in 30% and 70%, respectively. 2 The visual prognosis of CR depends on its localization and on macular complications. Choroidal neovascularization is associated with 20% of indirect CR.…”