Acute Suprachoroidal Hemorrhage Research Articles

Establishment of animal model Of acute suprachoroidal haemorrhage and its pathology

Background Expulsive choroidal haemorrhage is a severe complication during the intraocular operation.To create a feasible animal model of expulsive choroidal haemorrhage is very important for the study of its nature disease course and therefore prevention and treatment.Objecfive Present study was to modify the method of establishing acute choroidal haemorrhage animal model and explore the risk factor and pathogenesis mechanism.Methods The suprachoroidal explusive haemorrhage animal models were created by modifying the Zauberman method to ligate 2-4 vortex veins and rapidly intravenous injection of 250 ml normal solution to elevate the intraocular pressure(IOP),and then low the IOP by opening the anterior chamber via limbal incision.The bleeding of choroid and detachment of retina were examined by B-type ultrasound immediately,1,2 and 4 weeks after operation to assess the disease alteration with lapse of time.The samples of eyeballs were prepared in mentioned above time points for the histopathologieal evaluation of retina tissue.Results The animal models of suprachoroidal explusive haemorrhage were established bv this modified method with the successful rate 100％,and the manifestation resembled a clinical disease course.The shape,range and location of choroidal bleeding and retinal detachment were determined,and the diagnosis and change of suprachoroidal explusive haemorrhage with time were clarified using B-uhrasonography.The histopathological change revealed the breaking of Brueh's membrane and retinal pigmentary layer.It was verified that the dominant pathological change of retina was retinal destroy in 1 week after operation,and in 4 weeks after operation,the main pathological mechanism was proliferation of fibroblasts and collagen fiber. Conclusion The consequence procedure of modified Zauberman method,quickly intravenous injection of normal solution and puncture of the anterior chamber can create an ideal animal model of suprachoroidal explusive haemorrhage.The rapid IOP descent is a main risk factor of supraehoroidal explusive haemorrhage.The results of supraehoroidal explusive haemorrhage is severe destroy of retina and ehoroid.This study implies that supraehoroidal explusive haemorrhage is likely to be prevented and treated in the early stage. Key words: Suprachoroidal explusive haemorrhage; Risk factor; Choroid; Retina; B-ultrasonography; Animal model; Histopathology

Suprachoroidal Hemorrhage During Pars Plana Vitrectomy Associated with Valsalva Maneuver

Purpose: To report a suprachoroidal hemorrhage by Valsalva maneuver during vitrectomy under general anesthesia. Case summary: A healthy 26-year-old man had vitrectomy under general anesthesia due to rhegmatogenous retinal detachment in his right eye. During scleral indentation and endolaser photocoagulation, he took a sudden and severe bucking reflex because the effect of general anesthesia was insufficient. After the bucking reflex, suprachoroidal hemorrhage occurred in his right eye. Immediate IOP elevation and hyperfluorocarbon tamponade was performed to remove the suprachoroidal hemorrhage and reattach the retina and choroid. The patient’s corrected visual acuity was 20/50 and slender crescent‐shaped choroidal rupture remained around the temporal area of the macula, unlike traumatic choroidal rupture. Following fluorescein angiography, staining was evident at the choroidal rupture site; no fluorescein leakage was evident. Conclusions: We report a case of acute suprachoroidal hemorrhage which we investigated by fundus examination and fluorescein angiography. J Korean Ophthalmol Soc 49(6):1022-1027, 2008

Acute suprachoroidal hemorrhage during clear corneal phacoemulsification using topical and intracameral anesthesia

Shallowing of the anterior chamber and hardening of the eye occurred just before commencement of irrigation/aspiration of cortex in an 80-year-old man having temporal clear corneal cataract surgery under topical and intracameral anesthesia. Nucleus removal had been completed and was uneventful. Intraoperative fundus examination with the indirect ophthalmoscope disclosed a choroidal hemorrhage. The wound was immediately closed with sutures, and intravenous mannitol was administered. The hemorrhage remained localized. The red reflex remained unchanged at all times, and there was no prolapse of intraocular contents. A high index of suspicion is critical to the early diagnosis and management of choroidal hemorrhage.

Acute suprachoroidal hemorrhage during phacoemulsification

We present a case of acute suprachoroidal hemorrhage that developed during routine phacoemulsification in an 85-year-old patient after uneventful administration of periocular anesthesia. Pre-existing risk factors included advanced age, glaucoma, myopia, and hypertension. The scleral tunnel prevented major expulsion of intraocular contents; however, raised intraocular pressure prevented intraocular lens implantation. The rarity of this condition raises questions regarding the further management and precautions related to it.

Risk of acute suprachoroidal hemorrhage with phacoemulsification

Purpose: To establish whether small incision cataract surgery with phacoemulsification decreases the risk of acute suprachoroidal hemorrhage (ASCH) compared with traditional nucleus expression by extracapsular cataract extraction (ECCE).Setting: St. Erik Eye Hospital, Stockholm, Sweden.Methods: A retrospective study was done on the incidence of ASCH in cataract surgery between July 1990 and July 1996. During this period, 37,565 cataract extractions (phacoemulsification and ECCE) were performed at St. Erik Eye Hospital, combined procedures excluded. The criteria for diagnosis were the suspicion of ASCH during surgery and a verified diagnosis via an expulsive hemorrhage into the wound (4 cases), postoperative ultrasonic examination (20 cases), or a choroidal mass on performing ophthalmoscopy together with a postoperative history alluding to the diagnosis (2 cases).Results: Twenty-six eyes were identified with ASCH, including 7 during phacoemulsification and 19 during ECCE. The incidence of ASCH was 0.03% in the 23,213 phacoemulsification cases and 0.13% in the 14,352 ECCE cases. The difference was statistically significant (P = .0003; chi-square test).Conduslon: Small incision surgery with phacoemulsification decreased the risk of ASCH in cataract surgery compared with the traditional nucleus expression technique.