Choroidal Rupture Follow-up

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

Further Outpatient Care

Most CNV occurs within the first year. However, CNV has been reported to occur as late as 35 years after the choroidal rupture.

Regularly scheduled examinations with fluorescein angiography (as circumstances dictate) are recommended during the first year.

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Deterrence/Prevention

In view of the high risk of sustaining a traumatic choroidal rupture, protective eyewear should be mandatory when participating in paintball. [10, 11]

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Complications

In 15-30% of patients, CNV may arise and lead to a hemorrhagic or serous macular detachment with concomitant visual loss.

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Prognosis

Most patients with choroidal ruptures do not reach a final visual acuity of 20/40 or better. Poor visual acuity is associated with macular rupture and poor baseline visual acuity. [12]

If the rupture does not involve the fovea, good vision is expected.

A hemorrhagic or serous macular detachment secondary to CNV may threaten visual function.

If CNV is extrafoveal, it may respond well to laser photocoagulation. Few recurrences are reported after laser photocoagulation.

Bevacizumab is a humanized recombinant monoclonal IgG antibody that binds and inhibits all VEGF isoforms. A few series have reported beneficial results following intravitreal bevacizumab. [4, 5]

If CNV is juxtafoveal or subfoveal, consider pars plana vitrectomy with membrane extraction. Gross et al reported good visual acuities in a small case series. [9]

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Patient Education

Teach patients to self-monitor each eye by using an Amsler grid and a near card.

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