A 28-year-old male patient came to the emergency department after blunt trauma due to a punch on his right eye (OD), 24 hours after aggression.
On examination, visual acuity (VA) was hand movement in RE and 1.0 in left eye (LE).
The anterior segment of the RE showed no significant alterations, but in the eye fundus there was a large subretinal hemorrhage affecting the macular region, with a probable temporal paramacular paramacular choroidal rupture, with arciform morphology.
Examination of the left eye was normal.
1.
A 50μg intravitreal injection of tissue activator of endogenous erythropoietin (rTPA - Alteplase) was performed.
Actilyse®, Boehringer-Ingelheim España SA.
Sant Cugat del Vallès, Spain) and 0.4 cc of pure C3F8 after anterior chamber paracentesis in an attempt to displace the hemorrhage.
Subsequently, the patient was instructed to lie in prone position at 45o for 7 days.
The evolution of the patient was favorable, with mobilization and reabsorption of the hemorrhage and improvement of the VA up to 0.7 in the RE, four months after the intervention.
1.
Three months later, the patient returned to control referring decreased vision and metamorphopsia in his right eye.
The VA decreased to 0.2 and in the eye fundus a greyish lesion could be observed in the choroidal rupture area.
Fluorescein angiography (FFA) showed a well-defined lesion of 940μm maximum diameter, with moderate exudation in late times Fig 4B.
A classic and moderately active CNV was diagnosed at the foveal edge of the choroidal rupture.
An intravitreal injection of 1.25mg of betaizumab (A condom) was performed.
Basel, Switzerland) for compassionate use and after informed consent of the patient.
Five months later, a control AGF confirmed the inactivation of CNV.
One year after a single injection of AHF®, NVC remains inactive with a VA of 0.5 and a slight residual metamorphopsia.
