A 15-year-old girl presented with blurred vision after being hit by an elbow on her left eye. Her best-corrected visual acuity (BCVA) was 16/20. On fundus examination, both a choroidal rupture that formed a crescent shape concentric to the optic disc and a subretinal hemorrhage were detected (fig. ). Optical coherence tomography (OCT) showed that the juxtafoveal retinal pigment epithelial layer with Bruch's membrane was disrupted, and the inner segment/outer segment (IS/OS) of the photoreceptor junction and the external limiting membrane (ELM) layer were distorted with suspected pinpoint disruption (fig. ).\nAfter 3 weeks, her visual acuity reduced to counting fingers. Fundus examination revealed that the subretinal hemorrhage had absorbed and the choroidal rupture had expanded. The crescent-shaped window defect including the fovea was observed on fluorescein angiography (FAG) (fig. ). Wider disrupted layers of the RPE, the IS/OS junction, and the ELM at the corresponding area were detected in OCT. When compared with the first medical examination after the injury, the IS/OS junction and the RPE adjacent to the ruptured site were hardly distinguishable, although they were originally clearly observed (fig. ).\nSteroid pulse therapy (methylprednisolone 500 mg intravenous for 3 days and prednisolone 30 mg oral, tapering for 11 days) was started in another hospital, and 3 months after the injury, visual acuity increased to 20/125. Five months later, OCT revealed that the size of the expanded choroidal rupture had reduced, and the adjacent retina had improved sufficiently to distinguish the IS/OS junction and the RPE. However, FAG disclosed a choroidal neovascular membrane originating from the nasal edge of the choroidal rupture (fig. , fig. ). An intravitreal bevacizumab (Avastin, 1.25 mg/0.05 ml; Genentech, Inc., San Francisco, Calif., USA) injection was administered, and 1 month later, the patient's BCVA of the left eye had improved to 20/32, and the CNV had shrunk (fig. , fig. ). Also the IS/OS junction and the RPE had improved sufficiently and were able to be distinguished (fig. ).
A 14-year-old boy presented immediately after injury to the left eye. Examination of the left eye showed a total hyphema which cleared in seven days and vision improved to 6/9. Fundus examination revealed whitish yellow curvilinear lesion and sub-retinal blood []. The right eye was normal.\nSSOCT done seven days post injury showed discontinuity in the RPE/BM complex [] in one area, and there was blood lifting the ellipsoid and ELM layers. The ellipsoid layer was intact over the area but appeared less defined and thicker compared to adjacent ellipsoid layer. The defect in RPE/BM complex was 195 μm. Except for the innermost layers of the choriocapillaries, the outer choriocapillaries and the outer two layers of the choroidal vasculature seemed to be intact. In another area with sub-retinal blood, there was a gap in the RPE/ BM complex measuring about 454 μm []. One edge of the defect was shadowed by the retinal blood vessel over the region.\nOCT done through the same area as in 6 weeks later showed that gap in the RPE/BM complex was bridged with hyper-reflective reparative tissue and this tissue had incorporated the ellipsoid layer, ELM, and part of the outer nuclear layer in it and disrupted them. Some tissue proliferation was seen at the choriocapillary level too [].