Multimodal imaging analysis of retinal and choroidal microvascular abnormalities in a case of ocular decompression sickness

The imaging findings, temporal association with the diving accident, and short timeframe to resolution of this PED favor an etiology related to ocular decompression sickness. PED formation in this context may be secondary to 1) RPE dysfunction due to endothelial cell damage from free radicals and 2) choroidal ischemia resulting from gas emboli. To our knowledge, this is the first reported case where OCT-A has been used to demonstrate choroidal ischemia in ocular decompression sickness. The patient received hyperbaric oxygen treatments for several weeks following the accident which may have contributed to the rapid resolution of the PED supporting the role of choroidal ischemia in its pathogenesis.