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Thanos D Papakostas, Yoshihiro Yonekawa, David M Wu, John B. Miller, Peter B Veldman, Yewlin E Chee, Deeba Husain, Dean Eliott; Retinal detachment in traumatic chorioretinal rupture (sclopetaria). Invest. Ophthalmol. Vis. Sci. 2014;55(13):1119.
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Based on the current literature, retinal detachment (RD) is not associated with traumatic chorioretinal rupture (TCR, also known as sclopetaria). The purpose of this study is to present a series of patients with rhegmatogenous retinal detachment associated with TCR.
The records from 3 consecutive patients who sustained TCR were reviewed. The mechanism of TCR, initial presentation and visual acuity, extent of detachment and surgical management are presented
Case 1: A 40-year-old man presented one week after an injury with an 8 cm nail embedded in the right orbit extending into the frontal lobe. Visual acuity (VA) was light perception (LP) and there was dense vitreous hemorrhage. TCR and hemorrhagic choroidal detachment were noted as the vitreous hemorrhage cleared. Serial B-scans showed a new retinal detachment 2 weeks after presentation. The patient underwent pars plana vitrectomy (PPV) and lensectomy (PPL), peeling of tractional membranes (MP), and silicone oil (SO) tamponade. One month later, he developed a recurrent inferior detachment which was treated with a repeat PPV with a 180 degree inferior retinectomy and SO tamponade. Case 2: A 14-year-old boy sustained a BB pellet injury in his left orbit. VA was count fingers at one foot and he had vitreous hemorrhage and superior TCR. B-scan demonstrated an attached retina. The vitreous hemorrhage started to clear, but one month after the injury, he developed a new macula-off retinal detachment with a break superiorly at the edge of the TCR with proliferative vitreoretinopathy (PVR). The patient underwent PPV/scleral buckle (SB)/SO tamponade. Case 3: A 65-year-old man sustained a blast injury that resulted in a metallic foreign body that penetrated his right orbit and lodged in the left frontal lobe. VA was LP. Fundus exam revealed vitreous hemorrhage, bullous subhyaloid hemorrhage inferiorly and TCR superiorly. One week after the injury he developed a shallow RD noted on serial B-scans. He underwent a PPV/SB/MP/SO with a 180-degree superior retinectomy, and was also found to have subretinal hemorrhage and PVR. Three months later, the patient developed a recurrent inferior RD with PVR that was treated with a repeat PPV/PPL/180 degree inferior retinectomy and SO tamponade.
TCR can be associated with subacute RD in the post-traumatic period and these patients should be followed very closely
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