Indocyanine green angiographic features of choroidal rupture and choroidal vascular injury after contusion ocular injury.
OBJECTIVE
To report features of choroidal rupture and choroidal vascular injury after contusion ocular injury on indocyanine green angiography.


METHODS
In a prospective study, nine patients (nine eyes) with choroidal rupture after ocular contusion underwent initial fluorescein angiography and indocyanine green angiography within 19 days after trauma. Eyes that had a distinct abnormality of the retinal pigment epithelium were excluded from this study. Subtraction indocyanine green angiography was also performed. Follow-up fluorescein angiographic and indocyanine green angiographic findings were also studied.


RESULTS
Initial ophthalmoscopic examination revealed subretinal hemorrhage in all nine eyes. In five of the nine eyes, choroidal rupture was not seen on initial ophthalmoscopic or fluorescein angiographic examination because it was hidden beneath the subretinal hemorrhage, but it was detected on subsequent examinations. In the remaining four eyes, choroidal rupture was observed by ophthalmoscopy at the time of initial examination, and these eyes exhibited hyperfluorescent streaks on fluorescein angiography in the region of the subretinal hemorrhage. On initial indocyanine green angiography of all nine eyes, observed hypofluorescent streaks became more obvious with time. For each eye, there were more hypofluorescent streaks on indocyanine green angiography than hyperfluorescent streaks on fluorescein angiography. In one eye, the location of indocyanine green leakage nearly coincided with the location of a hyperfluorescent streak on fluorescein angiography. In this case, crescentic streaks of hypofluorescence were seen on the temporal side of the subretinal hemorrhage on indocyanine green angiography, although choroidal rupture was not observed in that region by ophthalmoscopy or fluorescein angiography. In two of the nine eyes, indocyanine green angiography and the subtraction technique demonstrated disturbance of flow into choroidal vessels, especially at the choroidal rupture site.


CONCLUSIONS
After ocular contusion injury, various features of choroidal rupture and choroidal vascular injury were observed on indocyanine green angiography. This technique may contribute to the diagnosis of choroidal rupture and to the understanding of the clinical course after injury.
Kohno
T
T
Department of Ophthalmology, Osaka City University Medical School, Osaka, Japan. takeya@med.osaka-cu.ac.jp
Miki
T
T
Shiraki
K
K
Kano
K
K
Hirabayashi-Matsushita
M
M
D000063:Accidents, Traffic; D000328:Adult; D001265:Athletic Injuries / Q000150:complications; D001808:Blood Vessels / Q000293:injuries / Q000473:pathology; D002199:Capillary Permeability; D002648:Child; D002829:Choroid / Q000098:blood supply* / Q000293:injuries* / Q000473:pathology; D015862:Choroid Diseases / Q000175:diagnosis* / Q000209:etiology; D003288:Contusions / Q000175:diagnosis* / Q000209:etiology; D005131:Eye Injuries / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D007208:Indocyanine Green; D008297:Male; D011446:Prospective Studies; D012166:Retinal Hemorrhage / Q000175:diagnosis; D012421:Rupture
D007208:Indocyanine Green