Resolution of Traumatic Retinal Detachment with Intravitreal Bevacizumab: a case report
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Abstract
Introduction: Traumatic retinal detachment (RD) without an observable break following ocular trauma is rare.
Case Report: A 14-year-old male who suffered from traumatic RD following an explosive injury. Initial examination revealed iridodialysis, vitreous haemorrhage, and impaired visual acuity in the right eye. One week later, the patient developed a macula-off retinal detachment secondary to subretinal exudation without an identifiable retinal break, and a decision was made to trial intravitreal injection (IVI) of bevacizumab before considering surgical intervention. Two days after IVI, significant improvements in subretinal fluid (SRF) were observed, and the retina remained attached during follow-up. The patient's visual acuity and anatomical outcomes improved, and no choroidal neovascularization (CNV) was detected at the 7-month follow-up.
Discussion: A rare instance of traumatic RD associated with choroidal rupture, and without an observable retinal break. While the majority of post-traumatic RD is due to pathological breaks, our case highlights the possibility of detachment secondary to exudation resulting from extensive haemorrhage and choroidal ruptura.
Conclusion: This case demonstrates the potential efficacy of anti-VEGF therapy in traumatic RD secondary to significant subretinal exudation and offers a less invasive treatment option for select cases, warranting further investigation and long-term studies for a larger patient cohort.
Keywords
Retinal Detachment; Bevacizumab; traumatic detachment
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References
2. Yalcin Tök O, Tok L, Eraslan E, Ozkaya D, Ornek F, Bardak Y. Prognostic factors influencing final visual acuity in open globe injuries. J Trauma. Dec 2011;71(6):1794-800. doi:10.1097/TA.0b013e31822b46af
3. Doi M, Osawa S, Sasoh M, Uji Y. Retinal pigment epithelial tear and extensive exudative retinal detachment following blunt trauma. Graefes Arch Clin Exp Ophthalmol. Jul 2000;238(7):621-4. doi:10.1007/s004170000155
4. Kahloun R, Abroug N, Ammari W, et al. Acute retinal periphlebitis mimicking frosted branch angiitis associated with exudative retinal detachment after blunt eye trauma. Int Ophthalmol. Oct 2014;34(5):1149-51. doi:10.1007/s10792-014-9958-0
5. Barth T, Zeman F, Helbig H, Gamulescu MA. Intravitreal anti-VEGF treatment for choroidal neovascularization secondary to traumatic choroidal rupture. BMC Ophthalmol. Nov 26 2019;19(1):239. doi:10.1186/s12886-019-1242-7
6. Piermarocchi S, Benetti E, Fracasso G. Intravitreal bevacizumab for posttraumatic choroidal neovascularization in a child. J AAPOS. Jun 2011;15(3):314-6. doi:10.1016/j.jaapos.2011.02.008
7. Wyszynski RE, Grossniklaus HE, Frank KE. Indirect choroidal rupture secondary to blunt ocular trauma. A review of eight eyes. Retina. 1988;8(4):237-43. doi:10.1097/00006982-198808040-00003
8. Conrath J, Forzano O, Ridings B. Photodynamic therapy for subfoveal CNV complicating traumatic choroidal rupture. Eye (Lond). Sep 2004;18(9):946-7. doi:10.1038/sj.eye.6701357
9. Wang SH, Lim CC, Teng YT. Airbag-Associated Severe Blunt Eye Injury Causes Choroidal Rupture and Retinal Hemorrhage: A Case Report. Case Rep Ophthalmol. 2017;8(1):13-20. doi:10.1159/000452652
10. Sheu SJ. Intravitreal ranibizumab for the treatment of choroidal neovascularization secondary to endogenous endophthalmitis. Kaohsiung J Med Sci. Nov 2009;25(11):617-21. doi:10.1016/S1607-551X(09)70566-2