Optical Coherence Tomography Angiography Findings in a Case of Choroidal Neovascularization Secondary to Traumatic Choroidal Rupture

Abstract

Background/Purpose: To document by optical coherence tomography angiography, the onset of a choroidal neovascularization (CNV) secondary to traumatic choroidal rupture and describe its changes after an intravitreal injection of bevacizumab. Methods: Case report. Results: A 20-year-old woman presented referring vision loss after a blunt ocular trauma in her left eye. The patient underwent a complete ophthalmic examination. Best-corrected visual acuity was 20/200. Fundus examination, fluorescein angiography, indocyanine green angiography, and optical coherence tomography displayed a choroidal rupture with no evidence of CNV. Optical coherence tomography angiography showed the choroidal rupture as a line of choriocapillaris rarefaction because of the mechanical damage. Six months later, best-corrected visual acuity decreased to 20/300; optical coherence tomography angiography displayed the growth of a CNV, characterized by a tangled vascular network. After one intravitreal injection of bevacizumab, optical coherence tomography angiography documented a contraction of the CNV. Conclusion: Optical coherence tomography angiography is a useful imaging technique for the diagnosis and follow-up of patients with choroidal ruptures. Anti–vascular endothelial growth factor agents represent an effective therapy for the treatment of CNVs secondary to this affection.

Foveal choroidal neovascularization secondary to accidental laser exposure in a dermatologist

“…CNV developed within 2 weeks, which is rapid compared to other secondary CNV causes such as traumatic choroidal rupture in which the CNV typically presents several months after the event. [8] In the present case, the laser energy reflected from the glass slide inflicted more damage to a small region of the retina, and resulted in more rapid progression of the CNV. From this perspective, thorough short-term follow-up is important in cases of laser-induced retinal injury.…”

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

“…demonstrated OCTA-guided evolution of posttraumatic CR-associated CNVM managed with single intravitreal bevacizumab in two separate reports. [ 14 15 ] Preziosa et al . described a defined tangled network of CNVM within a regular line of severe choriocapillary rarefaction corresponding to the area of CR by OCTA.…”

“…described a defined tangled network of CNVM within a regular line of severe choriocapillary rarefaction corresponding to the area of CR by OCTA. [ 14 ] In another report by Pierro et al ., the authors demonstrated CR by OCTA as breaks in the choroicapillary plexus with a hypointense appearance (due to lack of substance) with projection of underlying hyperintense choroidal vasculature along the break while the retinal vascular plexus was spared. However, there was no CNVM formation in this case.…”

“…Although there are a few case series describing the management of posttraumatic CR associated CNVM with anti-VEGF, the literature has very few isolated case reports demonstrating the use of OCTA in depicting the evolution of CR associated CNVM. [ 13 14 15 16 17 ] In the index report, we presented OCTA-guided the diagnosis of secondary CNVM following CR, where conventional FFA could not be performed and also showed its successful management with single injection of intravitreal ranibizumab.…”

Choroidal Neovascularization Associated with Rare Entities

“…OCT reveals SRF, IRF, and hyper-reflective subretinal material. Recently, OCT-angiography has been found useful in demonstrating neovascular tuft within choroidal rupture [118,119]. Care should be taken not to mistake projection artifacts from normal retinal or choroidal vessels with neovascularization.…”