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 Table of Contents  
OPHTHALMIC IMAGE
Year : 2022  |  Volume : 60  |  Issue : 2  |  Page : 205-206

Inverted 'Echinops Setifer' Shaped Traumatic Sign in the Fundus – Contemporaneous Subfoveal Choroidal Rupture with Epiretinal Membrane Post Blunt Trauma


1 Department of Glaucoma and Research, Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India
2 Department of Optometry and Visual Science, Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India
3 Department of Cataract and Refractive Surgery, Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India
4 Department of Vitreo-Retinal Services, Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India
5 Strabismus and Paediatric Ophthalmology, Mahathma Eye Hospital Private Limited, Trichy, Tamil Nadu, India

Date of Submission28-Dec-2021
Date of Decision26-Mar-2022
Date of Acceptance04-Apr-2022
Date of Web Publication30-Jun-2022

Correspondence Address:
Prasanna Venkatesh Ramesh
Mahathma Eye Hospital Private Limited, No. 6, Tennur, Seshapuram, Trichy - 620 017, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/tjosr.tjosr_187_21

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How to cite this article:
Ramesh PV, Devadas AK, Ray P, Ramesh SV, Balamurugan A, Ramesh MK, Rajasekaran R, Mohanty B. Inverted 'Echinops Setifer' Shaped Traumatic Sign in the Fundus – Contemporaneous Subfoveal Choroidal Rupture with Epiretinal Membrane Post Blunt Trauma. TNOA J Ophthalmic Sci Res 2022;60:205-6

How to cite this URL:
Ramesh PV, Devadas AK, Ray P, Ramesh SV, Balamurugan A, Ramesh MK, Rajasekaran R, Mohanty B. Inverted 'Echinops Setifer' Shaped Traumatic Sign in the Fundus – Contemporaneous Subfoveal Choroidal Rupture with Epiretinal Membrane Post Blunt Trauma. TNOA J Ophthalmic Sci Res [serial online] 2022 [cited 2022 Aug 12];60:205-6. Available from: https://www.tnoajosr.com/text.asp?2022/60/2/205/349518



A 29-year-old female patient presented with best corrected visual acuity of hand movements in the right eye (OD) 1-week after blunt trauma. On examination, the anterior segment was found to be normal and fundus [Figure 1] revealed subfoveal choroidal rupture with epiretinal membrane (ERM) in the shape of an inverted Echinops setifer flower. In this scenario, both inner and outer retinal layers were affected, with proliferation of glial cells forming ERM and subfoveal retinal pigment epithelium (RPE)–Bruch's membrane–choroidal complex disruption, respectively.[1],[2] According to the literature, there are no reports on a contemporaneous choroidal rupture with ERM developing within 1-week post-trauma. Optical coherence tomography (OCT) [Figure 2] was performed, and conservative management was advised.[3],[4],[5],[6],[7]
Figure 1: (a) Colour fundus image revealing the subfoveal choroidal rupture with contemporaneous epiretinal membrane (ERM) and surrounding internal limiting membrane (ILM) folds in the shape of an inverted Echinops setifer flower, 1-week post blunt trauma. (b) Infrared fundus image of the same pathology. (c) Autofluorescence fundus image of the same pathology. (d) Colour fundus image at 3-month follow-up, showing mild enlargement of ERM, with the concomitant development of subfoveal scarring, at the site of choroidal rupture

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Figure 2: (a) Optical coherence tomography (OCT) macula revealing retinal pigment epithelium (RPE)–Bruch's membrane–choroid complex disruption at the subfoveal region (red asterisk), with hyperreflective ERM (yellow arrow), performed when the patient presented to us 1-week after the trauma. The integrity of the IS/OS junction and neurosensory retinal layers are lost, with the subretinal fluid (green asterisk) at the foveal region, suggesting a poor visual prognosis. (b) OCT macula at 2-week, (c) 1-month, and (d) 3-month follow-up, showing the resolution of the subretinal fluid (green asterisk), enlargement of ERM (yellow arrow), and the concomitant development of subfoveal choroidal scarring (red asterisk)

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Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Choroidal Rupture-EyeWiki. Available from: https://eyewiki.aao.org/Choroidal_Rupture. [Last accessed on 2021 Sep 21].  Back to cited text no. 1
    
2.
Epiretinal Membrane-EyeWiki. Available from: https://eyewiki.aao.org/Epiretinal_Membrane. [Last accessed on 2021 Sep 21].  Back to cited text no. 2
    
3.
Ramesh PV, Ramesh SV, Rajasekaran R, Ramesh MK. Optical coherence tomography findings of photoreceptor-retinal pigment epithelium complex in acute traumatic maculopathy. Delhi J Ophthalmol 2021;31:97.  Back to cited text no. 3
    
4.
Arthur A, Rajasekaran NM, Kuriakose T. A reappraisal of indirect choroidal rupture using swept-source optical coherence tomography in-vivo pathology images in patients with blunt eye trauma. Indian J Ophthalmol 2020;68:2131-5.  Back to cited text no. 4
[PUBMED]  [Full text]  
5.
Ramesh PV, Ramesh SV, Aji K, Ray P, Balamurugan A, Rajasekaran R, et al. A case of ocular trauma manifesting as multiple choroidal ruptures and subretinal hemorrhages in a child. TNOA J Ophthalmic Sci Res 2022;60:68-70.  Back to cited text no. 5
  [Full text]  
6.
Ramesh SV, Ramesh PV, Ramesh MK, Rajasekaran R. Acute traumatic maculopathy. Kerala J Ophthalmol 2021;33:123-5.  Back to cited text no. 6
  [Full text]  
7.
Ramesh SV, Ramesh PV, Rajasekaran R, Ramesh MK. A rare presentation of bilateral subclinical macular commotio retinae. TNOA J Ophthalmic Sci Res 2020;58:318-9.  Back to cited text no. 7
  [Full text]  


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