Medscape is available in 5 Language Editions – Choose your Edition here.


Choroidal Rupture Treatment & Management

  • Author: Lihteh Wu, MD; Chief Editor: Hampton Roy, Sr, MD  more...
Updated: Mar 08, 2016

Medical Care

During the healing phase of virtually all choroidal ruptures, CNV is present. CNV may be thought of as part of the wound healing response. Most cases of CNV involute spontaneously. In up to 30% of patients, CNV may arise again and cause visual loss.

Prior to the advent of anti-VEGF therapy, good management options for subfoveal CNV were not really available; therefore, a conservative approach was recommended for most choroidal ruptures.

In the current era of anti-VEGF therapy, the extraordinary results obtained in CNV secondary to age-related macular degeneration have been extrapolated to other causes of CNV with apparent good results.[4, 5]

Currently available anti-VEGF agents include bevacizumab, ranibizumab, pegaptanib sodium, and aflibercept (see Medication).[6, 7]


Surgical Care

If CNV is extrafoveal, it may be treated successfully with laser photocoagulation. Recurrences seem few.[8]

Prior to the advent of anti-VEGF therapy, pars plana vitrectomy with membrane extraction was considered for subfoveal or juxtafoveal CNV.[9]

The role of photodynamic therapy with verteporfin is unclear; however, several case reports and case series using this treatment have shown encouraging results in these patients.

ICG-guided photocoagulation transiently closes feeder vessels of subfoveal CNV, but, eventually, these vessels become reperfused.

Currently, anti-VEGF therapy appears to have the most success.[5, 4]



Consult a vitreoretinal specialist.

Contributor Information and Disclosures

Lihteh Wu, MD Asociados de Macula Vitreo y Retina de Costa Rica

Lihteh Wu, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists, Association for Research in Vision and Ophthalmology, Club Jules Gonin, Macula Society, Pan-American Association of Ophthalmology, Retina Society

Disclosure: Received income in an amount equal to or greater than $250 from: Bayer Health; Quantel Medical; Heidelberg Engineering.


Dhariana Acón, MD Ophthalmologist, Caja Costarricense Seguro Social, Hospital de Guapiles, Costa Rica

Disclosure: Nothing to disclose.

Specialty Editor Board

Simon K Law, MD, PharmD Clinical Professor of Health Sciences, Department of Ophthalmology, Jules Stein Eye Institute, University of California, Los Angeles, David Geffen School of Medicine

Simon K Law, MD, PharmD is a member of the following medical societies: American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology, American Glaucoma Society

Disclosure: Nothing to disclose.

Steve Charles, MD Director of Charles Retina Institute; Clinical Professor, Department of Ophthalmology, University of Tennessee College of Medicine

Steve Charles, MD is a member of the following medical societies: American Academy of Ophthalmology, American Society of Retina Specialists, Macula Society, Retina Society, Club Jules Gonin

Disclosure: Received royalty and consulting fees for: Alcon Laboratories.

Chief Editor

Hampton Roy, Sr, MD Associate Clinical Professor, Department of Ophthalmology, University of Arkansas for Medical Sciences

Hampton Roy, Sr, MD is a member of the following medical societies: American Academy of Ophthalmology, American College of Surgeons, Pan-American Association of Ophthalmology

Disclosure: Nothing to disclose.

Additional Contributors

Russell P Jayne, MD Consulting Vitreoretinal Surgeon, The Retina Center at Las Vegas

Russell P Jayne, MD is a member of the following medical societies: American Medical Association, American Society of Cataract and Refractive Surgery, American Society of Retina Specialists

Disclosure: Nothing to disclose.


Teodoro Evans, MD Consulting Surgeon, Vitreo-Retinal Section, Clinica de Ojos, Costa Rica

Disclosure: Nothing to disclose.

  1. Sponsel WE, Gray W, Scribbick FW, Stern AR, Weiss CE, Groth SL, et al. Blunt eye trauma: empirical histopathologic paintball impact thresholds in fresh mounted porcine eyes. Invest Ophthalmol Vis Sci. 2011 Jul. 52(8):5157-66. [Medline].

  2. Liggett PE, Pince KJ, Barlow W, Ragen M, Ryan SJ. Ocular trauma in an urban population. Review of 1132 cases. Ophthalmology. 1990 May. 97(5):581-4. [Medline].

  3. White MF Jr, Morris R, Feist RM, Witherspoon CD, Helms HA Jr, John GR. Eye injury: prevalence and prognosis by setting. South Med J. 1989 Feb. 82(2):151-8. [Medline].

  4. Yadav NK, Bharghav M, Vasudha K, Shetty KB. Choroidal neovascular membrane complicating traumatic choroidal rupture managed by intravitreal bevacizumab. Eye (Lond). 2009 Sep. 23(9):1872-3. [Medline].

  5. Chanana B, Azad RV, Kumar N. Intravitreal bevacizumab for subfoveal choroidal neovascularization secondary to traumatic choroidal rupture. Eye. 2009 Jan 23. [Medline].

  6. Piermarocchi S, Benetti E, Fracasso G. Intravitreal bevacizumab for posttraumatic choroidal neovascularization in a child. J AAPOS. 2011 Jun. 15(3):314-6. [Medline].

  7. Heier JS, Brown DM, Chong V, Korobelnik JF, Kaiser PK, Nguyen QD. Intravitreal aflibercept (VEGF trap-eye) in wet age-related macular degeneration. Ophthalmology. 2012 Dec. 119(12):2537-48. [Medline].

  8. Fuller B, Gitter KA. Traumatic choroidal rupture with late serous detachment of macula. Report of successful argon laser treatment. Arch Ophthalmol. 1973 Apr. 89(4):354-5. [Medline].

  9. Gross JG, King LP, de Juan E Jr, Powers T. Subfoveal neovascular membrane removal in patients with traumatic choroidal rupture. Ophthalmology. 1996 Apr. 103(4):579-85. [Medline].

  10. Baath J, Ells AL, Kherani A, Williams RG. Severe retinal injuries from paintball projectiles. Can J Ophthalmol. 2007 Aug. 42(4):620-3. [Medline].

  11. Pahk PJ, Adelman RA. Ocular trauma resulting from paintball injury. Graefes Arch Clin Exp Ophthalmol. 2009 Apr. 247(4):469-75. [Medline].

  12. Ament CS, Zacks DN, Lane AM, et al. Predictors of visual outcome and choroidal neovascular membrane formation after traumatic choroidal rupture. Arch Ophthalmol. 2006 Jul. 124(7):957-66. [Medline].

  13. Aguilar JP, Green WR. Choroidal rupture. A histopathologic study of 47 cases. Retina. 1984 Fall-Winter. 4(4):269-75. [Medline].

  14. Bellows JG. Observations on 300 cases of ocular war injuries. Am J Ophthalmol. 1947. 30:309-323.

  15. Conrath J, Forzano O, Ridings B. Photodynamic therapy for subfoveal CNV complicating traumatic choroidal rupture. Eye (Lond). 2004 Sep. 18(9):946-7. [Medline].

  16. Eagling EM. Ocular damage after blunt trauma to the eye. Its relationship to the nature of the injury. Br J Ophthalmol. 1974 Feb. 58(2):126-40. [Medline].

  17. Harissi-Dagher M, Sebag M, Gauthier D, Marcil G, Labelle P, Arbour JD. Photodynamic therapy in young patients with choroidal neovascularization following traumatic choroidal rupture. Am J Ophthalmol. 2005 Apr. 139(4):726-8. [Medline].

  18. Hart JC, Natsikos VE, Raistrick ER, Doran RM. Indirect choroidal tears at the posterior pole: a fluorescein angiographic and perimetric study. Br J Ophthalmol. 1980 Jan. 64(1):59-67. [Medline].

  19. Hilton GF. Late serosanguineous detachment of the macula after traumatic choroidal rupture. Am J Ophthalmol. 1975 Jun. 79(6):997-1000. [Medline].

  20. Leys A, Dralands L, Missotten L. Late complications of choroidal ruptures. Bull Soc Belge Ophtalmol. 1981. 193:137-41. [Medline].

  21. Luxenberg MN. Subretinal neovascularization associated with rupture of the choroid. Arch Ophthalmol. 1986 Aug. 104(8):1233. [Medline].

  22. Mehta HB, Shanmugam MP. Photodynamic therapy of a posttraumatic choroidal neovascular membrane. Indian J Ophthalmol. 2005 Jun. 53(2):131-2. [Medline].

  23. Mennel S, Hausmann N, Meyer CH, Peter S. Photodynamic therapy and indocyanine green guided feeder vessel photocoagulation of choroidal neovascularization secondary to choroid rupture after blunt trauma. Graefes Arch Clin Exp Ophthalmol. 2005 Jan. 243(1):68-71. [Medline].

  24. Pearlstone AD. Delayed loss of central vision following multiple posterior segment trauma. Ann Ophthalmol. 1980 Apr. 12(4):409-11. [Medline].

  25. Secretan M, Sickenberg M, Zografos L, Piguet B. Morphometric characteristics of traumatic choroidal ruptures associated with neovascularization. Retina. 1998. 18(1):62-6. [Medline].

  26. Smith RE, Kelley JS, Harbin TS. Late macular complications of choroidal ruptures. Am J Ophthalmol. 1974 May. 77(5):650-8. [Medline].

  27. Von Graefe A. Zwei falle von ruptur der choroida. Graefes. Arch Clin Exp Ophthalmol. 1854. 1:402.

  28. Wood CM, Richardson J. Chorioretinal neovascular membranes complicating contusional eye injuries with indirect choroidal ruptures. Br J Ophthalmol. 1990 Feb. 74(2):93-6. [Medline].

  29. Wyszynski RE, Grossniklaus HE, Frank KE. Indirect choroidal rupture secondary to blunt ocular trauma. A review of eight eyes. Retina. 1988. 8(4):237-43. [Medline].

A 23-year-old man was in a motor vehicle accident 2 months before his presentation. His visual acuity is 20/400, and an afferent pupillary defect is present. Traumatic optic neuropathy and choroidal rupture are observed. This is a red-free photograph. (Courtesy of Jorge Gutierrez, MD.)
Mid-phase fluorescein angiogram in a 23-year-old man who was in a motor vehicle accident 2 months before his presentation. (Courtesy of Jorge Gutierrez, MD.)
Late-phase fluorescein angiogram in a 23-year-old who man was in a motor vehicle accident 2 months before his presentation. (Courtesy of Jorge Gutierrez, MD.)
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.