Choroidal ischemia secondary to a diving injury.

Purpose: To report a case of choroidal ischemia in a professional diver after a decompression sickness accident.

Methods: A 31-year-old man presented a decompression sickness accident without any systemic manifestation. The symptoms were exclusively ophthalmic with sudden decrease of vision and presence of scotoma predominantly on the left eye immediately after a dive. The patient had a complete clinical ophthalmologic examination as well as fluorescein angiography, optical coherence tomography, central visual field, visual-evoked potentials, and electroretinogram examinations that were repeated during the follow-up over a period of 18 months.

Results: The examinations performed 1 week after the decompression sickness accident and the hyperbaric oxygen therapy showed diminution of foveal reflectivity associated with retinal pigment epithelium modifications, deficit of choroidal perfusion in the macular region, and important central scotoma in both eyes. During the follow-up, the central scotoma disappeared after 6 months. The retinal pigment epithelium presented pigmentary migrations without subretinal fluid accumulation.

Conclusion: This case report describes choroidal ischemia resulting from decompression-induced intravascular gaseous microemboli caused by a decompression sickness diving accident.