Effect of ocular contusion in a patient with chronic central serous chorioretinopathy.
OBJECTIVE
We report the effect of ocular contusion in a patient with chronic central serous chorioretinopathy and posterior cystoid retinal degeneration.


METHODS
A 56-year-old man who being followed for recurrent-chronic central serous chorioretinopathy presented with blurred vision in the left eye 6 days after contusion of the eye by a soccer ball. Previously, the left eye had received multiple laser treatments in the papillomacular region resulting in a large chorioretinal scar. Photodynamic therapy also had been performed in the chronic phase of the disease. Optical coherence tomography 2 months before the trauma showed cystoid retinal changes at the site of the laser scar and no fluid in the fovea.


RESULTS
When the left eye was examined after the contusion, visual acuity was 20/40. Funduscopic examination did not show retinal opacities. Optical coherence tomography revealed cystoid intraretinal cavities and retinal detachment that extended from the scar to the fovea. Indocyanine green angiography showed choriocapillaris hyperpermeability at the posterior pole that was not present at previous examinations. The retinal detachment resolved in 1 month whereas the new cystoid retinal changes disappeared over the course of 8 months. Visual acuity returned to the baseline value of 20/26.


CONCLUSIONS
This case shows that a contusion injury of the eye can produce a temporary pattern of macular exudation with worsening of posterior cystoid retinal degeneration in chronic chorioretinopathy. Findings observed in this patient support the concept that chorioretinal adherence at the site of a laser scar may have a critical role in the development of posterior cystoid retinal degeneration in central serous chorioretinopathy.
From the Fondazione per la Macula Onlus, Genova, Italy.
Felice
F
Cardillo Piccolino