Abstract
IntroductionWe present a case of spontaneous suprachoroidal haemorrhage in a patient taking Warfarin. This is only the second case reported of a patient whose anticoagulation was within the therapeutic range.Case presentationAn 84 year old white male with a history of end stage atrophic age related macular degeneration presented with angle closure glaucoma. The patient was taking warfarin and had a therapeutic International Normalized Ratio (INR). Ultrasound examination revealed a spontaneous suprachoroidal haemorrhage.ConclusionAnticoagulation is common in those with cardiovascular disease, which increases the risk of haemorrhagic complications. These patients are also more likely to suffer from age related macular degeneration. Suprachoroidal haemorrhage should be considered in such patients presenting with suspicious signs and a low threshold should be had for investigating for this condition in such circumstances. Early detection may reduce the morbidity.
Highlights
We present a case of spontaneous suprachoroidal haemorrhage in a patient taking Warfarin
Anticoagulation is common in those with cardiovascular disease, which increases the risk of haemorrhagic complications
These patients are more likely to suffer from age related macular degeneration
Summary
Anticoagulation is common in the elderly, amongst those with cardiovascular disease, which increases the risk of haemorrhagic complications. These patients are more likely to suffer from age related macular degeneration. The physician needs to have a high level of suspicion in elderly patients on anticoagulation presenting with suspicious signs. This should be the case in those presenting with open. INR: International Normalization Ratio; SCH: Suprachroidal Haemorrhage; SSCH: Spontaneous Suprachoroidal Haemorrhage; RE: Right Eye; LE: Left Eye; VA: Visual Acuity; CF: Counting Fingers; HM: Hand Movements; IOP: Intraocular Pressure; ARMD: Age Related Macular Degeneration
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