A Case Report of Conservative Management for a Roller-Coaster-Related Vitreous Haemorrhage

Abstract

The purpose of this report is to describe the case and management of an unexplained vitreous haemorrhage that occurred after repeated roller-coaster riding. The authors inadvertently demonstrate the value of observation over immediate surgery in certain situations and review the literature on vitreoretinal and other ocular complications after roller-coaster riding. A 26-year-old male presented 12 h after riding high-velocity roller-coasters with a left vitreous haemorrhage. A hazy view of the retina and B-scan revealed a bullous area of superior-temporal retinal lifting. A diagnosis of a presumed macula-on retinal detachment was made and the patient was listed for a pars plana vitrectomy retinal detachment repair. An abnormal clotting result, which was subsequently found out to be erroneous, ultimately delayed the procedure. During this delay the vision and retinal view improved to an extent whereby the diagnosis of a retinoschisis with an intraretinal cyst was made and surgery was avoided. The patient regained 6/6 vision, without the need to undergo surgery. Historically the management of an unexplained vitreous haemorrhage was observation with serial B-scans. The current evidence and practice for treating unexplained vitreous haemorrhage have since moved towards early surgical intervention. The authors highlight that despite the current trend, a place remains for conservative management for selected cases.

Retinal giant cyst treated by the scleral buckling procedure : a case report

“…She also had a brief history of severe coughing before the onset of vision loss, and we hypothesized that her condition may have been due to the presence of a small retinal cyst prior to the severe coughing, which was stimulated by severe coughing and resulted in enlargement of the cyst and rupture of the cyst and hemorrhage. Alexander et al [11] also reported a case of retinoschisis with intraretinal cyst hemorrhage due to roller coaster riding. Keith [1] and Sen and Mishra [6] reported a similar case of retinal cleavage with a large retinal cyst.…”

“…Currently, the treatment of retinal cysts has been reported to be inconsistent. Cai et al [10] concluded that vitrectomy combined with retinotomy is very effective in removing large cysts and providing adequate relief from retinal traction, but Brent et al [11] emphasized that there is still a place for conservative treatment. This case report describes the use of scleral buckling with external compression combined with external drainage of intracystic uid for the treatment of a large intraretinal cyst with retinal cleavage.…”

Retinal giant cyst treated by the scleral buckling procedure: A case report

“…[8][9][10] Currently, the treatment of retinal cysts has been reported to be inconsistent. Cai et al [11] concluded that vitrectomy combined with retinotomy is very effective in removing large cysts and providing adequate relief from retinal traction, but Brent et al [6] emphasized that there is still a place for conservative treatment. This case report describes the use of scleral buckling with external compression combined with external drainage of intracystic fluid for the treatment of a large intraretinal cyst with retinal cleavage.…”

“…She also had a brief history of severe coughing before the onset of vision loss, and we hypothesized that her condition may have been due to the presence of a small retinal cyst prior to the severe coughing, which was stimulated by severe coughing and resulted in enlargement of the cyst and rupture of the cyst and hemorrhage. Alexander et al [ 6 ] also reported a case of retinoschisis with intraretinal cyst hemorrhage due to roller coaster riding. Keith [ 1 ] and Sen and Mishra [ 7 ] reported a similar case of retinal cleavage with a large retinal cyst.…”