Traumatic chorioretinal folds treated with intra-vitreal triamcinolone injection
A 34-year-old male was injured in a car accident. Facial computed tomography showed multiple facial fractures []. Best-corrected visual acuity (BCVA) was 20/20 in the right eye and 10-cm hand motion in the left eye. Spherical equivalents were -1.25 D in the right eye and -6.50 D in the left eye, which showed myopic changes. IOP was 17 mmHg in the right eye and 8 mmHg in the left eye. Fundus examination revealed vitreous hemorrhage and retinal hemorrhage. SD-OCT (Cirrus HD-OCT, Carl Zeiss Meditec, Dublin, CA, USA) showed a lamellar macular hole [].\nThree days after the injury, BCVA was 20/2000 and IOP was 9 mmHg in the left eye, and SD-OCT showed chorioretinal folds and choroidal vasodilation. Two weeks after the injury, facial reconstruction for multiple facial fractures was performed at the department of plastic surgery in our hospital []. One month after the injury, fundus examination revealed constant chorioretinal folds, vitreous hemorrhage, retinal vascular tortuosity, and SD-OCT showed undulations of the RPE–Bruch's membrane complex and choroidal vasodilation in the posterior pole, and no progression of lamellar hole to full-thickness macular hole [].\nTreatment with topical prednisolone acetate and systemic prednisolone (30 mg/day) for 3 months led to absorption of the vitreous hemorrhage but no improvement in visual acuity, IOP, or chorioretinal folds, and spherical equivalents changed to -0.50 D in the left eye. After 12 months of treatment there was still no significant change in BCVA. Fundus examination showed retinal vascular tortuosity and continuous chorioretinal folds in the posterior pole region of the left eye []. The young patient wanted no more delay in treatment and hoped for more aggressive treatment. Through full explanation of the expected effects and possible complications of IVTI, informed consent was obtained from the patient before injection and intra-vitreal injections were performed using standard techniques. One week after IVTI (4 mg/0.1 ml), BCVA was 20/400 and IOP was 8 mmHg in the left eye. Six months after injection, BCVA was 20/100 and IOP was 14 mmHg in the left eye. Fundus photography revealed that retinal vascular tortuosity had disappeared and SD-OCT showed improvement of the chorioretinal folds and choroidal vasodilation [].