Posterior pole retinal tears following blunt ocular trauma

American Journal of Ophthalmology Case Reports
Anfisa AyalonAlexander Rubowitz

Abstract

Posterior pole retinal tears occur rarely following blunt trauma. We describe a case of traumatic macular tears, without concurrent peripheral retinal tears or holes. A 17-year-old patient presented to our emergency unit with blunt ocular trauma and multiple maxillofacial fractures after being assaulted. On examination visual acuity was 20/200 in the left eye with scant vitreous and preretinal hemorrhages. Funduscopic examination revealed multiple choroidal ruptures running concentrically to the optic disc, a subretinal macular hemorrhage, and a large macular tear in the area of the inferior vascular arcade just temporal to the macula. Optical coherence tomography revealed subretinal fluid in the foveal area, choroidal ruptures and a slight elevation of the macular retinal tear margins without subretinal fluid. Laser retinopexy was performed around the macular tear nasally. On follow-up, the retina in the lasered area remained flat, while a shallow retinal detachment had developed temporal to the tear, with a second tear appearing supero-temporally to the macula. Laser retinopexy was not possible due to surrounding subretinal hemorrhage. The clinical course was later complicated by macular detachment, necessitating pars plana v...Continue Reading

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