TREATMENT AND PATHOGENESIS OF TRAUMATIC CHORIORETINAL RUPTURE (SCLOPETARIA)

Eight eyes (seven patients) with traumatic chorioretinal rupture (sclo petaria) from severe ocular trauma were examined. All seven patients w ere referred with diagnoses of retinal detachment, giant retinal tear, or ruptured globe. Instead, all eyes had large, peripheral, full-thic kness breaks of the choroid and retina without retinal detachment. Sev en of eight eyes were initially managed by observation only; one eye w as treated with a scleral buckling procedure. The retina remained atta ched in all eyes for at least six months. Late retinal detachment (mor e than one year after initial injury) occurred in two eyes because of retinal breaks at a site distant from the original chorioretinal ruptu re. Two eyes later developed vitreous hemorrhage associated with poste rior vitreous detachment and one of these eyes required vitrectomy to clear the visual axis. The pathogenesis of sclopetaria appears to be m echanical disruption and retraction of tissue rather than acute tissue dissolution. The risk of acute retinal detachment is low. We recommen d nonsurgical management for the initial treatment of these patients, with continued observation for complications that may later occur.