Spontaneous Suprachoroidal Hemorrhage Research Articles

Unilateral scleral icterus due to spontaneous suprachoroidal hemorrhage.

Unilateral scleral icterus due to spontaneous suprachoroidal hemorrhage.

Spontaneous suprachoroidal haemorrhage: clinical features, visual outcomes and prognosis factors.

To describe clinical features, risk factors and outcomes of patients with diagnosis of rare spontaneous suprachoroidal haemorrhage (SSCH) over a 20-year period from a tertiary eye unit. Retrospective, observational case-series of patients with SSCH, defined as SCH without a known cause at diagnosis. Variables analysed included age, gender, ethnicity, systemic and ocular comorbidities, systemic medication, initial and final best corrected visual acuity (BCVA), clinical features, management and follow-up. Total of 11 eyes of 11 patients were identified. Median age was 70 years (SD 25.9). Most patients were female (82%) and white British. Median follow-up period was 2.2 years. Hypertension was the most frequently associated underlying systemic disease (45%) and 36% were on anti-coagulant or anti-platelet therapy. High myopia was observed in 36% of cases. Presenting BCVA of 1.00 logMAR or better was a positive predictor of final BCVA. No significant improvement in the initial versus final BCVA was found in patients who underwent surgery versus those who remained under observation. Patients over 60 years-old with hypertension, anticoagulant treatment, high myopia, and pseudophakia were common. Visual outcomes were poor, surgical intervention had limited impact. Good initial BCVA predicted better final acuity while extensive SSCH correlated with poorer visual results. Despite the study's limitations, this series offers valuable insights into visual prognosis and prognostic factors.

Bilateral Spontaneous Suprachoroidal Hemorrhage after Systemic Tissue Plasminogen Activator

Bilateral Spontaneous Suprachoroidal Hemorrhage after Systemic Tissue Plasminogen Activator

Massive Spontaneous Suprachoroidal Hemorrhage in a Patient With Type 1 Chronic Myeloid Leukemia and Lymphoplasmacytic Lymphoma: Case Report and Review of the Literature.

This work reports a rare case of spontaneous suprachoroidal hemorrhage (SSCH) and summarizes the literature on its treatment options and outcomes. A case report and comprehensive literature review are presented on the medical and surgical management of SSCH on PubMed from 1998 to 2021. The literature search revealed 58 studies, 33 of which included 52 eyes of 47 patients. Surgical treatment typically consisted of choroidal drainage with posterior sclerotomies combined with pars plana vitrectomy and silicone oil placement. Medical therapy involved intraocular pressure control with laser peripheral iridotomy and topical, oral, and intravenous medication. In cases of SSCH, conservative management and a prompt workup should be initiated to identify the cause before proceeding with surgery. If the initial workup does not reveal a cause, medical and surgical treatments are both viable and the decision is at the discretion of the treating physician.

Spontaneous suprachoroidal haemorrhage in haemophilia coincident with ChAdOx1 nCoV-19 vaccine.

To report a case of spontaneous suprachoroidal haemorrhage in a haemophilia patient immediately following ChAdOx1 nCoV-19 vaccination. A 60-year-old man with haemophilia developed painful vision loss in his left eye a day following the ChAdOx1 nCoV-19 vaccination due to acute angle-closure glaucoma from a massive suprachoroidal haemorrhage. He had an extremely deranged coagulation profile; activated partial thromboplastin time (APTT): 89 s, normal range 29-35 s After factor VIII transfusion, ocular hypotensive therapy and systemic/topical steroids, the suprachoroidal haemorrhage and glaucoma resolved, but the vision remained poor. Spontaneous suprachoroidal haemorrhage may be seen in haemophiliacs with deranged coagulation profiles. In our case, it followed ChAdOx1 nCoV-19 vaccination, and we recommend caution and checking the coagulation profile in such patients apriori.

Spontaneous Suprachoroidal and Orbital Hemorrhage in an Older Woman Associated with Prophylactic Antiplatelet Therapy: A Case Report and Literature Review

Spontaneous Suprachoroidal and Orbital Hemorrhage in an Older Woman Associated with Prophylactic Antiplatelet Therapy: A Case Report and Literature Review

A rare case of spontaneous expulsive suprachoroidal haemorrhage in a glaucomatous eye treated with topical alpha-adrenergic agonist.

Spontaneous expulsive suprachoroidal hemorrhage is a rare ocular condition, which usually occurs after sudden decompression of the eyewall. Most of the cases of expulsive hemorrhage reported had a predisposing glaucoma with the combination of corneal pathology. We are reporting a case of spontaneous expulsive suprachoroidal hemorrhage in a glaucoma patient probably due to perpetuated inflammatory reaction and frequent eye rubbing induced by allergic reaction to topical alpha adrenergic agonist in a compromised cornea.

A rare case of acute angle closure due to spontaneous suprachoroidal haemorrhage secondary to loss of anti-coagulation control: a case report

BackgroundSuprachoroidal haemorrhage is a rare complication of either medical anticoagulation treatment or intraocular surgical procedures. Suprachoroidal haemorrhages often have devastating visual outcome despite conservative and/or surgical intervention.Case presentationA patient with known Open Angle Glaucoma and Atrial Fibrillation on warfarin presents symptoms and signs suggestive acute angle closure. Examination reveals the underlying cause is a large, macula involving, spontaneous suprachoroidal haemorrhage secondary to loss of anti-coagulation control. Following aggressive medical treatment and surgical intervention, including drainage combined cataract extraction with intraocular lens implant, pars-plana vitrectomy, and external drainage of suprachoroidal haematoma, we managed to preserve the patient’s eye and some of its function.ConclusionSpontaneous suprachoroidal haemorrhages are rare complications of loss of anticoagulation control. Our case shows that aggressive treatment in selected cases can offer a relatively good outcome.

Blinding spontaneous suprachoroidal haemorrhage in anticoagulant taking wet-AMD patients

We present cases of blinding spontaneous suprachoroidal haemorrhage in anticoagulant taking wet-AMD patients. A retrospective study has been performed to present the clinical course, management and final outcome of spontaneous suprachoroidal haemorrhage in 7 eyes of six age-related macular degeneration patients seen in our clinic from January 2016 to April 2017. All patients were on chronic oral anticoagulant therapy because of cardiovascular disorder. In one patient, haematological disorder was also present modifying significantly the haemostasis. All eyes received prior anti-VEGF treatment for exsudative AMD. Acute angle closure glaucoma - with no response to topical and oral IOP lowering therapy - was the most frequent ocular complication in our cases. The final visual prognosis was usually very poor. The risk of spontaneous suprachoroidal haemorrhage is increased in wet-AMD patients who are on anticoagulant therapy. To prevent this blinding condition, a stronger communication between ophthalmologists and cardiologists would be beneficial, with an ophthalmological check-up in this group of patients before and during the use of anticoagulants. Orv Hetil. 2018, 159(24): 985-990.

Spontaneous suprachoroidal haemorrhage with exudative retinal detachment in pregnancy-induced hypertension

A 35-year-old woman at 26 weeks’ gestation presented with vision loss in the right eye (RE) and abdominal pain for 10 days. There was no fever. RE had conjunctival congestion...

A Case of Acute Angle-closure Glaucoma Secondary to Spontaneous Suprachoroidal Hemorrhage

A Case of Acute Angle-closure Glaucoma Secondary to Spontaneous Suprachoroidal Hemorrhage

Spontaneous suprachoroidal hemorrhage: Case report and review of the literature

We present the clinical course, management, and final outcome of spontaneous suprachoroidal hemorrhage (SSCH) in an age-related macular degeneration (AMD) patient—a 64-year-old male receiving antiplatelet therapy who developed SSCH during the Valsalva maneuver. In addition to our case study, we discuss the results of a systemic review of the literature and reference lists of retrieved studies published from January 2001 to December 2013. Among a total of 31 patients (32 eyes), acute secondary glaucoma was a complication in 87.5% of the cases, and over half of the cases (20 eyes, 62.5%) received surgery. Twenty cases (64.5%) were characterized by systemic hypertension (HTN), followed by cardiovascular or cerebral vascular disease in 17 cases (54.8%). The Valsalva maneuver was performed in five cases (16.1%) prior to the episode. Twenty-three cases (74.2%) had abnormal hemostasis, including use of anticoagulants or thrombolytic agents (18 cases), chronic renal failure (CRF, 5 cases), and blood dyscrasia (3 cases). AMD was the most common (17 eyes of 16 patients, 53.1%) ocular disease. Visual acuity was classified as hand motion (HM) or worse in 20 eyes (of 28 eyes, 71.4%) at initial presentation and in 24 eyes (of 30 eyes, 80%) upon final examination. Anticoagulated patients with AMD should be informed of the risk of intraocular hemorrhage. Medical therapy usually fails in the treatment of glaucoma. Surgical intervention provides an option for the purpose of pain relief. Even so, the final visual prognosis is usually poor.

Massive Spontaneous Suprachoroidal Hemorrhage in a Patient with Heavy Alcohol Consumption

Massive Spontaneous Suprachoroidal Hemorrhage in a Patient with Heavy Alcohol Consumption

Rhegmatogenous retinal detachment associated with massive spontaneous suprachoroidal hemorrhage and prognosis of pars plana vitrectomy.

To describe the clinical characters of rhegmatogenous retinal detachment (RRD) associated with massive spontaneous suprachoroidal hemorrhage (SSCH). To evaluate optimal timing and prognosis of pars plana vitrectomy. A retrospective review of 6 cases (6 eyes) of RRD and massive SSCH among 3772 cases of RRD was conducted. All of 6 patients were treated with twenty-gauge vitrectomy, suprachoroidal blood drainage, phacoemulsification (PHACO) or lensectomy and silicon oil tamponade. The clinical characters, intraoperative findings and treatment outcomes were reported. In the 6 affected eyes of 6 patients (3 men and 3 women; mean age, 53.83y; range 34-61y), preoperative visual acuity ranged from faint light perception (LP) to counting finger (CF). The average interventional duration from visual decreased to surgery was 12.8 d (range 9-15d). All eyes were associated with high myopia and the mean ocular length was 30.32 mm (range 28.14-32.32 mm). Choroidal hemorrhage were successfully drained in the operation of all 6 eyes. Intraoperative findings showed there were multiple retinal breaks in all 6 eyes and in 4 eyes breaks were along supratemporal and/or infratemporal retinal vascular arcade, especially in the edge of chorioretinal atrophy areas. These patients were followed up from 6 to 34mo (Mean, 23.5mo). The best-corrected visual acuity after surgery varied from CF to 20/100, with improvement in 5 eyes (83.33%) and no change in 1 eye (16.67%). Ocular hypertension ocurred in 1 eye (16.67%), which was successfully treated by silicon oil removal combined with trabeculectomy. In 4 eyes, tractional retinal detachment caused by proliferative vitreoretinopathy (PVR) appeared and a secondary surgery of pre-retinal membrane peeling and silicon oil retained were performed. In 4 eyes, silicon oil cannot be removed. The initial and final reattachment rates were 33.33% and 66.67%, respectively. RRD associated with massive SSCH is an extremely rare event. The most common risk factor is long axial length. Vitrectomy and choroidal blood drainage can effectively remove suprachoroidal hemorrhage and promote retinal reattachment in these eyes. However, silicon oil could not be removed in most eyes and final visual acuities are generally poor.

Spontaneous expulsive suprachoroidal hemorrhage caused by decompensated liver disease

Expulsive suprachoroidal hemorrhage can be surgical or spontaneous. Spontaneous expulsive suprachoroidal hemorrhage (SESCH) is a rare entity. Most of the reported cases of SESCH were caused by a combination of corneal pathology and glaucoma. We are reporting a rare presentation of SESCH with no pre-existing glaucoma or corneal pathology and caused by massive intra- and peri-ocular hemorrhage due to decompensated liver disease.

Abrupt spontaneous suprachoroidal hemorrhage post-23-gauge vitrectomy during peritoneal dialysis

Herein, we report a case of abrupt suprachoroidal hemorrhage (SCH) that developed during peritoneal dialysis in a patient with proliferative diabetic retinopathy. A 53-year-old female patient visited our clinic with blurred vision due to vitreous hemorrhage and proliferative diabetic retinopathy. Her medical history included diabetes, hypertension, chronic renal failure, and she had received scheduled peritoneal dialysis. No anticoagulant agents were used. We performed combined phacoemulsification with intraocular lens implantation and vitrectomy without any complications. Two hours later, the retina was stable and the intraocular pressure (IOP) was 11 mmHg. Four hours later, while receiving peritoneal dialysis, she abruptly developed ocular pain. Examination of her eye revealed an IOP of 38 mmHg and a SCH in the entire peripheral retina and posterior pole. At 12 hours after surgery (on the same day), the SCH was found to be further aggravated, and because a “kissing retina” was imminent, silicone oil was injected. An attempted fluid–air exchange failed because there was not enough space to fill with silicone oil due to aggravation of the SCH. Sclerotomies were performed to remove the SCH, and to create space for the silicone oil injection. Two months after surgery, the silicone oil was removed and her visual acuity was found to have improved to 20/40, but the patient died of pontine hemorrhage 1 month later. SCH can occur in vitrectomized eyes due to an increase in abdominal pressure during peritoneal dialysis, because chronic renal failure patients with diabetes and hypertension have structural vulnerabilities and vascular weaknesses due to arterial sclerosis in response to the increased blood pressure.

MASSIVE SPONTANEOUS SUPRACHOROIDAL HEMORRHAGE IN A YOUNG WOMAN WITH CYSTIC FIBROSIS AND DIABETES MELLITUS ON ANTICOAGULANTS

To report a case of massive spontaneous suprachoroidal hemorrhage in a young woman with cystic fibrosis and proliferative diabetic retinopathy on anticoagulant therapy. Single case report. A 24-year-old woman with cystic fibrosis and diabetes mellitus developed a massive spontaneous suprachoroidal hemorrhage in the left eye after two months of warfarin therapy and recent treatment with heparin. Fundus examination and B-scan ultrasonography of the left eye revealed a hemorrhagic choroidal detachment. Elevated intraocular pressure was controlled with brimonidine, but four months later the left eye ceased to perceive light. Massive spontaneous suprachoroidal hemorrhage (SSCH) is a rare event that occurs almost exclusively in patients of advanced age. To our knowledge, this is the youngest patient with SSCH described in the literature. Regardless of age or other medical conditions, anticoagulant therapy appears to be a strong risk factor. SSCH carries a poor visual prognosis with or without surgical intervention.

Perioperative spontaneous bilateral suprachoroidal hemorrhage

Suprachoroidal hemorrhage is a rare condition, occurring most commonly in the perioperative period, although cases of unilateral spontaneous hemorrhages have been reported. We report a case of bilateral spontaneous suprachoroidal hemorrhage and discuss the potential causative factors.

Spontaneous Suprachoroidal Hemorrhage Associated with Wet Type of Age-Related Macular Degeneration and Hypertension: Two Cases

Spontaneous Suprachoroidal Hemorrhage Associated with Wet Type of Age-Related Macular Degeneration and Hypertension: Two Cases

A spontaneous suprachoroidal haemorrhage: a case report

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.