A previously healthy, 19-year-old male presented for a visit in our department at 15–20 National Ophthalmology Institute with complaints of bilateral decreased visual acuity. He reported a blunt trauma on both eyes 8 days before due to resistance band (Fig. ) used for strengths exercises at home. He went through ophthalmological examination in another department the day of the trauma. At the visit, best-corrected visual acuity (BCVA) in right eye (RE) was 20/400 and 20/1,000 in the left eye. Slit-lamp examination did not show any scleral wound, corneal wound, or traumatism of the lens. Air-puffed intraocular pressure (IOP) was 14 mm Hg in the RE and 16 mm Hg in the left eye (LE). Air-puffed IOP device was used due to the risk of unknown scleral perforation in this traumatic context. Devices were cleaned with sanitizing spray after each examination, and a time-period of 15 min was respected between each patient examination in accordance with Hygiene Department guidelines. Fundus examination showed bilateral preretinal hemorrhages not allowing further examination. B-ultrasonography revealed no evidence of retinal tears or retinal detachment. No treatment has been started. The patient could not be referred initially to a reference center due to national lockdown while COVID-19 was spreading. One week later, BCVA was below 20/200 on RE and 20/1,000 on LE. IOP was 12 mm Hg on both eyes. Fundus examination after a 7-day delay recorded inferotemporal rupture of Bruch membrane on RE and inferior diffuse preretinal hemorrhages on both eyes. Fundus autofluorescence demonstrated increased autofluorescence in traumatic pigment epitheliopathy (Fig. ). Peripheral retinal examination was normal. Spectral-domain OCT (Heidelberg Engineering Inc., Heidelberg, Germany) showed bilateral increased reflectivity, disruption of the inner/OS (IS/OS), and loss of the external limiting membrane in the macular area (Fig. ). A full-thickness thin macular hole was present only on RE. Retinal thickness was decreased below 200 μm at the sites of the lesions. We decided to introduce oral steroids therapy 40 mg a day. The patient has been notified of the poor prognosis. The 6-week follow-up revealed a BCVA at 20/80 on RE and 20/63 on LE. The fundus examination showed a slight decrease of preretinal hemorrhages on both eyes. Spectral-domain OCT (Heidelberg Engineering Inc., Heidelberg, Germany) showed a spontaneous closure of macular hole on RE, and however, outer retinal layers remained atrophic on both eyes (Fig. ). No macular hole was present on left eye. The subject had given his written informed consent for publication of its case.
A 13-year-old boy presented with 5 months old injury to the left eye. Examination of the left eye showed iris sphincter tears with angle recession. A curvilinear stellate yellowish gray lesion was seen just nasal to the fovea with associated gray-white lesion at the fovea []. The right eye was normal.\nSSOCT showed hyper-reflective, disorganized tissue involving RPE/BM complex, ellipsoid layer, external limiting membrane (ELM), and outer nuclear layer. This presumed scar tissue also involved the choriocapillary layer and the Sattler's layer. The Haller's layer was only minimally involved []. Scar tissue was also seen extending on the surface of the RPE away from the presumed site of rupture. The yellowish gray lesion seen at the posterior pole seemed to correspond to the areas where OCT showed the hyper-reflective scar tissue. No evidence of a full thickness BM or choroidal discontinuity could be made out.\nOCT angiogram (OCTA) showed the inner retinal capillaries to be intact. The outer retinal capillary layer showed some decreased vascular marking in the area of the scar. At the level of the photoreceptor and RPE, there was a discontinuity in the tissue pattern corresponding to the scar. Surrounding this discontinuity, there were new vessels. At the level of the choriocapillaries besides discontinuity in the vascular pattern due to scar tissue, there seemed to be increased vascularity along the rupture site itself [].