Clinical histopathology of intrachoroidal splitting in open-globe injury: A retrospective case series of four patients

PURPOSE: The purpose of this study is to observe the characteristics of intrachoroidal splitting (ICS) associated with choroidal detachment due to open-globe injury. METHODS: A retrospective, observational case series study of four eyes diagnosed with choroidal detachment exhibited ICS. The in vivo pathologic changes of the ICS were recorded during surgery. Four specimens were obtained from the inner part of the ICS region. One specimen was stained with hematoxylin and eosin; one specimen was examined under scanning electron microscopy, and the other two specimens were examined under transmission electron microscopy. RESULTS: All four patients presented with vortex vein rupture associated with large-scaled mid-peripheral ICS. The histopathologic observations indicated that ICS occurred between the medium-sized and large-sized choroidal vessel layers. Large vascular indentations and medium-sized choroidal vessels were observed on the inner part of the split interface. Postoperative outcomes of the four patients were poor. Vision in all four patients was no light perception before or after surgery. Three eyes became atrophic with silicon oil tamponade and band keratopathy, one eye was eventually enucleated for cosmetic reason. CONCLUSION: Intrachoroidal tissue has the potential to split during trauma. The outcome of ICS with choroidal detachment in open-globe injury was poor.