Choroidal rupture.

Abstract

Choroidal rupture resulting from ocular trauma is classified as direct or indirect, depending on the location of the lesion. Direct ruptures occur at the site of impact and are usually located anteriorly and parallel to the ora serrata; the more common indirect ruptures occur in the posterior pole and are usually concentric to the optic nerve. There are two theories proposed to explain the pathogenesis of injury. The most significant sequela of choroidal rupture is formation of a choroidal neovascular membrane (CNVM). Patients with good acuity and rupture in close proximity to the macula should be monitored; fluorescein angiography may be used as an aid to diagnosis. Early-onset CNVM occurs within 6 months after injury, whereas the late-onset form of CNVM may require many years to pass before becoming clinically evident. Laser photocoagulation is used to arrest the growth of the neovascular membrane in both types of presentations.