Multimodal imaging features in chorioretinitis sclopetaria

Abstract

Purpose: To describe the multimodal imaging findings in a case of chorioretinitis sclopetaria (CS). Methods: Single case report. Results: A 26‐year‐old male reported a history of ocular injury to the right eye (OD) in childhood caused by a palm tree branch after which he underwent cataract surgery. On examination, his best‐corrected visual acuity was light perception in OD. Anterior segment examination revealed the presence of an anterior chamber intraocular lens. Intraocular pressure was within the normal range. Dilated funduscopy showed an area of bare sclera in the inferonasal quadrant adjacent to a white fibroglial proliferation that extended to the nasal and temporal periphery consistent with CS. A large area of chorioretinal atrophy involving the macular region with a nasal demarcation line and scattered hyperpigmented patches was also noted. The left eye examination was unremarkable. Fundus autofluorescence showed hypoautofluorescence of the scar tissue and in the posterior pole. Swept‐source optical coherence tomography scans confirmed the rupture of the choroid underneath a full‐thickness hyperreflectivity in the inferonasal quadrant and revealed disruptions in the macular RPE and outer retinal layers. Conclusions: CS is caused by a shock wave from a high‐velocity projectile resulting in the tearing of the choroid, retinal pigment epithelium (RPE), and neurosensory retina which later induces fibrous scarring, RPE hyperplasia, and photoreceptor loss. Multimodal imaging findings of CS are consistent with these features.