Post-Traumatic Choroidal Rupture: Characteristics, Management and Outcomes.

Abstract

To describe the clinical features, management, and outcomes of post-traumatic choroidal ruptures. This retrospective consecutive case series included patients with Bruch's membrane ruptures following ocular trauma. Clinical records, multimodal imaging, and treatment outcomes were reviewed. A total of 26 patients (27 eyes) with post-traumatic choroidal rupture were included. Mean age at presentation was 27.4±16.3 years, with a male predominance (65%). Most ruptures were submacular (55%) and arc-shaped (52%), commonly associated with subretinal hemorrhage (74%) or commotio retinae (63%). Choroidal neovascularization (CNV) developed in 11 eyes (41%) at a median interval of 62 days after trauma and was effectively controlled in most cases with a limited number of intravitreal anti-VEGF injections, leading to significant functional and anatomical improvement. Seventy percent of eyes with CNV needed 5 injections or less to control CNV activity. Eyes without CNV also demonstrated significant visual gains. Final outcomes were similar between eyes with and without CNV. Additional complications included full-thickness macular hole (19%) and epiretinal membrane (15%). Trauma is a common cause for choroidal rupture. Post-traumatic choroidal rupture primarily affects young males and most often involves the submacular region. Choroidal neovascularization developed in nearly half of eyes within weeks of trauma but was generally well-controlled with anti-VEGF therapy, resulting in meaningful visual recovery. Despite frequent associated complications, most patients experienced improved vision over time, underscoring the importance of long-term monitoring and timely treatment.