LAUSR

A man in his 50s with blurred vision and visual acuity of 20/25 OS was observed after sustaining blunt ocular trauma with a branch of a tree to the left eye. Fundus examination revealed angioid streaks in both eyes with multiple choroidal ruptures in the left eye (Figure, A). There were no signs of peau d’orange changes in the retina (temporal to the central macula) in either eye. The patient had not been evaluated previously for pseudoxanthoma elasticum. The ruptures were hyperfluorescent on angiography (Figure, B). Sixteen months after presentation, the patient developed secondary choroidal neovascularization with visual acuity loss to 20/200 OS. Scar tissue later developed, but the visual acuity remained stable at 20/200 OS. Because of the fragility of the Bruch membrane in patients with angioid streaks, especially secondary to pseudoxanthoma elasticum,1 choroidal rupture may occur with minor trauma so patients should be educated about wearing eye protection.