Central serous chorioretinopathy resolution after traumatic cyclodialysis repair

外伤性睫状体分离修复术后中心性浆液性脉络膜视网膜病变消退

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Abstract

To report a rare case of central serous chorioretinopathy resolution after traumatic cyclodialysis repair. Observation: A 66-year-old Japanese woman was referred to our hospital with a visual disturbance in her right eye (OD). She had a history of blunt ocular injury when hit by a carton box 3 years previously, but the best-corrected visual acuity (BCVA) was 1.0. At the initial visit, the BCVA was 0.3 OD and 1.2 in the left eye (OS). Optical coherence tomography (OCT) showed a serous retinal detachment (SRD) in the macula; the submacular choroid was thicker OD (316 μm) than OS (246 μm). Fluorescent fundus angiography showed a subretinal macular leak. Gonioscopy and anterior-segment OCT showed angle recession and a cyclodialysis cleft at the temporal angle and cyclodialysis in the four quadrants. One month after focal photocoagulation was applied to the leakage point, the retinal detachment had not improved and the BCVA worsened to 0.2. After subsequent surgical repair of the cyclodialysis using an ab interno approach, the ciliochoroidal detachment resolved by 1 month with a simultaneous rapid decrease in the SRD and complete resolution by 2 months. At the final visit, 5 months postoperatively, the BCVA was 1.0 OD. During this period, the choroidal thickness decreased to 264 μm OD but was unchanged at 247 μm OS. Conclusion and Importance: Traumatic cyclodialysis, presumably via choroidal venous overload, can cause CSC. Since the presence of mild cyclodialysis and/or ciliochoroidal detachment may be difficult to find, post-traumatic CSC during the chronic phase of ocular trauma might be overlooked.

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