A 7-year old boy presented 1 day after injury to the right eye. The left was normal. The right eye vision was 6/18. There were abrasions on the cornea. Anterior chamber had cells of 1+ and flare of 2+. Fundus examination showed a double humped sub-foveal bleed. The retina over the macula looked edematous clinically. OCT done at presentation showed blood between the RPE and ellipsoid layer. The ellipsoid and ELM layer over the blood lost its clear distinction and looked thickened due to edema. OCT line scan showed two areas of breaks in the RPE/BM complex measuring 103 and 185 μm [ pre]. One week later since the sub-macular blood persisted, he underwent pars plana vitrectomy, sub retinal tissue plasminogen activator injection, and SF6 gas replacement of the vitreous cavity using the technique described previously.[] A month later the vision improved to 6/9. The fundus picture and OCT line scan after surgery is shown in . Clinically macular area showed multiple stellate lines under the retina that did not correspond to areas of choroidal rupture. The ELM layer and ellipsoid layer were continuous under the foveola. There was scar tissue between the photoreceptor layer and RPE corresponding to the yellowish gray area under the fovea seen clinically. Full thickness neurosensory retinal defect was seen at the site of retinotomy. The RPE/BM complex break near the retinotomy was plugged with scar tissue. There were some cystic changes in the margin of the retinotomy site. At the site of the rupture corresponding to the area in pre, there was scarring and closure of the BM break like in the previous two cases [ post].\ngives an overview of the cases presented. As has been noted above besides a break in the BM, the SSOCT showed blood between RPE and ellipsoid layer, and variable amounts of edema of the inner retinal layers in all the three acute cases. The gap in the BM ranged from 103 to 465 μm. The inner neuro-sensory retina and the Sattler's and Haller's layers of the choroid did not show any disruption in the acute stage.\nOCT after a month of the injury showed scar tissue involving Sattler's layer, choriocapillary layer, BM, RPE, ellipsoid layer, ELM, and outer nuclear layer in all the cases.
A 11-year-old boy presented with a 12-day old injury to the left eye. Examination revealed traumatic uveitis and mydriasis in the left eye. Fundus examination of the left eye showed a curved yellowish gray sub-retinal lesion at the macula involving the fovea []. Minimal sub-retinal bleed and a resolving vitreous hemorrhage were also noted. The right eye was normal.\nSSOCT scan done at presentation showed a break in the RPE/BM complex measuring 465 μm at the fovea. There was hyper reflective tissue extending from the outer nuclear layer of the retina to the choriocapillary layer. Ellipsoid and ELM layer could not be made out clearly [].\nTwo weeks later when the inflammation cleared, the vision improved to 6/18 from 6/60 in the left eye. Seven weeks after injury, the vision dropped to 6/36 and the SSOCT showed fibrous tissue invading all the neuro-retinal layers at the foveola []. In one area, fibrous tissue was seen extending into the vitreous cavity too []. There were a few cystic areas seen in the nuclear layers of the retina. OCTA showed normal inner and outer retinal layer vascularization. The tissue pattern at the level of the RPE was absent in the area of the rupture with no new vessels. At the level of the choriocapillaries, there were vessels in the scar tissue [].