TRAUMATIC AND TOXIC RETINOPATHIES

Penetrating and Perfurating Ocular Trauma - Clinical Case 3

37-year-old patient with blunt trauma and rupture of the ocular globe. Presents with sclero-uveal rupture, hyphema, vitreous hemorrhage, peripheral and temporal retinal tear, subretinal hemorrhages, and multiple serous retinal detachments.

BCVA: 20/25 RE, nine years after surgeries (scleral suturing of external rectus muscle disinsertion, PPV and laser photocoagulation at the margin of the retinal tear, inferior retinal detachment with proliferative vitreoretinopathy and subretinal fluid containing some blood; epiretinal membrane peeling and ILM maculorrhexis).

Evaluations

1st Evaluation - 22 12 2012

Echography

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Anterior Segment Photo

Scleral and uveal rupture; fibrin clot in the pupillary area; hyphema.

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2nd Evaluation - postoperative - 07 01 2013

Colour retinography

Hemovitreous; tear in the temporal retina.

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Anterior Segment Photo

12 days after surgery (scleral suturing of the disinsertion of the external rectus muscle – images 1 and 2). Vitreous hemorrhage. Hemovitreous.

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3rd Evaluation - postoperative - 08 01 2013

Infrared

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Anterior Segment Photo

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Colour retinography

1 day after surgery. Surgery images (VPP and laser photocoagulation at the edge of the retinal tear).

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OCT (B-Scan) longitudinal

Multiple serous detachments (OCT 5 and 6)

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4th Evaluation - 17 01 2013

Autofluorescence

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Infrared

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Red-free

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Colour retinography

Inferior retinal detachment

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Anterior Segment Photo

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OCT (B-Scan) longitudinal

Epiretinal membrane (cellophane maculopathy)

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5th Evaluation - postoperative - 01 03 2013

Autofluorescence

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Infrared

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Red-free

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Colour retinography

Two weeks after surgery (inferior retinal detachment with proliferative vitreoretinopathy and subretinal fluid with some blood; epiretinal membrane peeling and ILM maculorrhexis performed); note the gas bubble.

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OCT (B-Scan) longitudinal

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6th Evaluation - 18 01 2019

Autofluorescence

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Infrared

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Colour retinography

BCVA: 20/20 RE. Seven years after the trauma.

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Anterior Segment Photo

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OCT (B-Scan) longitudinal

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7th Evaluation - 16 12 2021

Autofluorescence

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Infrared

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RNFL – Thickness Image

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Colour retinography

BCVA: 20/25 RE. nine years after the trauma.

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Anterior Segment Photo

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OCT (B-Scan) longitudinal

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