Partial Avulsion of Posterior Pole: A Rare Case Report

Purpose: To report a rare case of partial avulsion of posterior pole that presented as partial separation of choroid layers from sclera at posterior pole with iridodialysis, caused by extreme blunt trauma during a road traffic accident. Methods: Choroidal avulsion is a serious subtype of ocular trauma, defined as a severe separation of choroid membrane from the sclera and irregular choroidal residuals on the scleral wall usually accompanied by the detachment or avulsion of ciliary body at the corresponding quadrant, caused by a sudden external force burst. We present a rare case of post traumatic choroidal avulsion at posterior pole that considered due to its unique findings as partial avulsion of posterior pole. The patient was a 24-year-old male with a previous history of road traffic accident with severe blunt trauma to periocular area in the last days of ocular examinations. The patient complained of decreased visual acuity after the trauma in the affected eye. Main ocular findings were iridodialysis, vitreous hemorrhage at inferior of the vitreous cavity, intra-retinal hemorrhage and retinal folds at posterior pole of the affected eye. In further investigations via multimodal imagings including ocular B-scan ultrasonography and optical coherence tomography (OCT), the patient had partial choroidal separation from the sclera at the posterior pole with some residuals were attached on the sclera in the affected area and secondary adjacent retinal folds. Results: Due to acute phase of injury, we observed the patient with follow-up visit before any decision making for vitreoretinal surgeries including pars plana vitrectomy. Conclusion: In patients with a history of severe blunt trauma to ocular and periocular areas, careful clinical and para clinical investigations is necessary to find some rare but important complications such as choroidal avulsion which may be undiagnosed by ophthalmologists.