Management and prognosis of vitreous haemorrhage

Abstract

AbstractVitreous haemorrhage is one of the most common causes of sudden deterioration in vision with an incidence of seven cases per 100 000 and it is affecting most often only one eye.The most common causes for nontraumatic, spontaneous vitreous haemorrhage include diabetic retinopathy, retinal tear/detachment, vitreoretinal traction resulting from posterior vitreous detachment, retinal venous occlusive disease, ruptured retinal macroaneurysm, and exudative age‐related macular degeneration In the setting of severe vitreous haemorrhage and no visualization of the fundus and without a history of underlying cause the diagnosis may be challenging. B‐scan is the most useful diagnostic tool but ultrasound has limitations both in sensitivity and specificity for excluding retinal tear and detachment, as well as operator dependent variability. General ophthalmologists tend to follow up patients, waiting the haemorrhage to clear or to have some indication for the underlying pathology. This waiting time could compromise the final visual outcome of a vitreous haemorrhage related to retinal breaks or affect the quality of life of patients. With the safety profile of modern small gauge vitreoretinal surgery we would suggest an early referral of all cases to vitreoretinal surgeons as delayed diagnosis and management could implicate consequences affecting the final visual result.