Choroidal Rupture Treatment & Management

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

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]

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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]

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Consultations

Consult a vitreoretinal specialist.

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