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Delayed-Onset White-Dot Syndrome in the Setting of Traumatic Choroidal Rupture.

Alina Husain¹, James P Winebrake², Naomi R Goldberg³

¹Department of Ophthalmology, and MD Program, Weill Cornell Medicine, New York, NY, USA.

Journal of Vitreoretinal Diseases

|February 3, 2025

Summary

A tennis ball injury caused a traumatic choroidal rupture and submacular hemorrhage. This led to delayed posterior uveitis, mimicking white-dot syndromes, in a young man.

Keywords:

choroidal rupture posterior uveitis submacular hemorrhage white-dot syndrome(s)

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Area of Science:

Ophthalmology
Retinal Diseases
Uveitis

Background:

Traumatic choroidal rupture can lead to vision loss.
Submacular hemorrhage is a serious complication.
Delayed-onset uveitis is an uncommon sequela.

Observation:

A 34-year-old man sustained a traumatic choroidal rupture and submacular hemorrhage from a tennis ball injury.
Initial treatment with topical agents and intravitreal aflibercept failed to prevent vision decline.
Optical coherence tomography revealed optic disc edema and placoid outer retinal lesions.

Findings:

The patient developed delayed-onset posterior uveitis with features resembling white-dot syndromes.
Despite aggressive treatment, visual acuity worsened significantly.
Resolution was achieved with oral corticosteroids, suggesting an inflammatory etiology.

Implications:

Traumatic choroidal rupture may trigger immune responses in the subretinal space.
This case highlights a potential link between trauma, choroidal rupture, and autoimmune-like uveitis.
Understanding this pathway may inform future management strategies for similar injuries.