Spontaneous suprachoroidal hemorrhage in a high myopia patient with rhegmatogenous retinal detachment: a case report and literature review

Chai, Fang; Zeng, Lizhong; Li, Chunhua; Zhao, Xiquan

doi:10.1042/bsr20181454

Cited by 13 publications

(21 citation statements)

References 42 publications

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“…Myopic patients were particularly prone to intraoperative SCH and postoperative RD in our series. [ 14 ] This implies that myopic patients subjected to combined procedures need to be counseled appropriately before surgery and rigid steps should be taken for timely identification and management of these complications. Or else, whenever possible, staged procedures can be performed for these patients.…”

Section: Discussionmentioning

confidence: 99%

Surgical outcomes of concomitantly performed penetrating keratoplasty with intrascleral haptic fixation

Agarwal

Yadav²,

Maharana³

et al. 2021

Indian Journal of Ophthalmology

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Purpose: To describe the surgical results of concomitantly performed optical penetrating keratoplasty (PKP) with glued intrascleral haptic fixation (ISHF). Methods: Retrospective review of 18 patients (15–72 years) with best-corrected visual acuity (BCVA) of ≤1/60 subjected to unilateral concomitant optical PKP with ISHF and followed up for 13.11 ± 5.83 months (6–26 months) was undertaken. Results: The most common diagnoses were failed PKP (9/18, 50%) followed by aphakic bullous keratopathy (5/18, 27%). Preoperative glaucoma, peripheral anterior synechiae (PAS), and deep vascularization were present in 7/18 (38.88%), 12/18 (61.11%), and 5/18 (27.77%) patients, respectively. Intraoperatively, concomitant procedures such as pupilloplasty and intraocular lens explant were undertaken in 5/18 (27.277%) patients and 1/18 patients (5.55%) experienced suprachoroidal hemorrhage. At final follow-up, BCVA was ≥6/60 in 50% patients (mean astigmatism: 4.79 ± 1.68D), and 55.55% cases experienced graft failure (90% failed within one year of surgery). The most common causes of graft failure were glaucoma (50%), glaucoma with rejection (20%), rejection (10%), retinal detachment (10%), and suprachoroidal hemorrhage (10%). The ODDS ratio (OR) of having graft failure with the following factors was postoperative secondary interventions (OR: 6), postoperative complications (OR: 2.25), prior failed graft (OR: 1.8), preoperative PAS (OR: 1.75), intraoperative concomitant procedures (OR: 1.5), preoperative glaucoma (OR: 1.33), previous surgeries (OR: 1.24), and deep corneal vessels (OR: 0.66). Conclusion: All patients underlying PKP combined with glued ISHF must be counseled about suboptimal surgical outcomes. Emphasis is laid on appropriate case selection and stringent follow-up during the first year after surgery. Secondary interventions should be undertaken cautiously and judiciously in these patients.

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Section: Discussionmentioning

confidence: 99%

Surgical outcomes of concomitantly performed penetrating keratoplasty with intrascleral haptic fixation

Agarwal

Yadav²,

Maharana³

et al. 2021

Indian Journal of Ophthalmology

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“…While surgically related SCH is known to be linked with systemic risk factors such as advanced age, cardiovascular disease (CVD), including arterial hypertension, atherosclerosis, and coagulation disorders, as well as diabetes and asthma 1 , their association with SSCH has only been identified recently. Ocular conditions such as age-related macular degeneration (AMD), glaucoma, and pseudophakia also seem to be correlated with SSCH 3 , 4 , 5 . However, the few literature reviews on “spontaneous” SCH do not clearly indicate if or when a previous intraocular surgery took place 3 , 4 .…”

Section: Introductionmentioning

confidence: 99%

“…Ocular conditions such as age-related macular degeneration (AMD), glaucoma, and pseudophakia also seem to be correlated with SSCH 3 , 4 , 5 . However, the few literature reviews on “spontaneous” SCH do not clearly indicate if or when a previous intraocular surgery took place 3 , 4 . Also, the literature describes a poor visual outcome following an episode of SSCH 3 , 4 .…”

Section: Introductionmentioning

confidence: 99%

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Valsalva-Induced Spontaneous Suprachoroidal Hemorrhage: A Case Report and Review of the Literature

Bijon

Schalenbourg

2022

Klin Monbl Augenheilkd

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We report a rare case of spontaneous suprachoroidal hemorrhage and present a systematic review of the literature using PubMed/Medline databases. Patients that developed a spontaneous suprachoroidal hemorrhage with a history of previous intraocular surgery were excluded. An 82-year-old male patient with no known ocular pathologies or surgical history was referred with acute ocular pain and decreased vision in the right eye (BCVA: 0.6 with hyperopic correction) following a Valsalva maneuver. General history included chronic heart failure and coronary artery disease, treated with anticoagulant and antihypertensive drugs. Dilated fundus examination revealed a posterior red-brown choroidal mass, with a thickness of 1.5 mm on B-scan ultrasonography. The lesion was not visible on fluorescein or indocyanine green angiography and was located under the choroid on B-scan optical coherence tomography. The diagnosis of a spontaneous suprachoroidal hemorrhage was evoked, and the patient was observed. Five months later, BCVA was 1.0 uncorrected, with a normal-appearing fundus. In a literature review, eight cases of spontaneous suprachoroidal hemorrhage following an episode of increased intrathoracic pressure were identified, including our patient. M/F ratio was 1 : 1, with a median age of 66.5 years. All cases presented systemic pathologies. All cases presented with a unilateral suprachoroidal hemorrhage. Only 2/8 patients had ocular comorbidities. Complications requiring treatment were noted in 4/8 cases, including 2 cases that resulted in the loss of the vision following an acute angle-closure glaucoma. Spontaneous resolution of the hemorrhage was observed in the other 4 patients. In 6/8 cases, vision recovered over a mean period of 10 weeks. In conclusion, spontaneous suprachoroidal hemorrhage following a Valsalva maneuver in eyes with no history of ocular surgery or trauma is rare, and has been associated with advanced age, cardiovascular disease and asthma. In severe cases (2/8) the eye was lost, while most cases (6/8) recovered, presenting a good visual outcome.

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“…It has been described in patients with or without preexisting retinal pathologies such as high myopia, proliferative diabetic retinopathy, and age-related macular degeneration. [ 2 ] Systemic risk factors include carotid artery disease, chronic renal failure, diabetes mellitus, systemic hypertension, use of oral anticoagulants, and thrombolytic. [ 3 ] The successful management of the suprachoroidal hemorrhage often leads to the resolution of heterochromia.…”

mentioning

confidence: 99%

Heterochromia iridum with sudden vision loss in an elderly man – A trick to treat

Panda¹,

Kanungo

Nanda

2021

J Emerg Trauma Shock

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Spontaneous suprachoroidal hemorrhage in a high myopia patient with rhegmatogenous retinal detachment: a case report and literature review

Cited by 13 publications

References 42 publications

Surgical outcomes of concomitantly performed penetrating keratoplasty with intrascleral haptic fixation

Surgical outcomes of concomitantly performed penetrating keratoplasty with intrascleral haptic fixation

Valsalva-Induced Spontaneous Suprachoroidal Hemorrhage: A Case Report and Review of the Literature

Heterochromia iridum with sudden vision loss in an elderly man – A trick to treat

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