This 36YO male presented with one week of vision loss in his right eye immediately following a bungee cord injury. Vision was 20/60.
Optos color RG imaging shows areas of subretinal blood surrounding the inferior optic nerve and superotemporal macula. Multiple choroidal ruptures are evident. On Triton swept-source OCT, the superotemporal choroidal rupture appears as an outer retinal hyperreflective mound, and the blood as hyporeflective mounds between the outer retina and RPE.
Our patient was treated with observation, and one month later, all blood resolved with 20/100 vision.
Learning Points:
An acute submacular hemorrhage following blunt trauma almost always indicates an underlying choroidal rupture as the source of the blood. The final vision is usually good unless the rupture extends through the macular center. These patients need long-term follow-up due to the increased risk of macular neovascularization.
