Abstract
Purpose
To report a case of a 60-year-old female with rhegmatogenous retinal detachment, presenting with suprachoroidal hemorrhage after vitrectomy.
Case summary
A 60-year-old woman visited our clinic complaining of floaters, flashing, and blurred vision. Best-corrected visual acuity was 0.1 in her left eye, and fundus examination of her left eye revealed macula-involved retinal detachment with a retinal break at the superotemporal quadrant. She underwent cataract surgery, 23-gauge transconjunctival sutureless vitrectomy, and 14% C3F8 gas tamponade under general anesthesia. One hour after anesthesia recovery, she suddenly complained of severe pain in her left eye. The intraocular pressure measured after removal of the pressure patch from her left eye was as high as 58 mmHg. Her ocular pain improved spontaneously within 10 minutes, and the intraocular pressure decreased to 8 mmHg. Fundus examination of her left eye revealed a reddish-brown raised lesion, suggesting suprachoroidal hemorrhage. She was placed in a prone position with a pressure patch over her left eye. Bleeding through the sclerotomy site was observed 1 day after surgery. Subsequently, hemorrhagic choroidal detachment of her left eye continued to decrease without deterioration. Three weeks after surgery, the patient received an intravitreal injection of 100% C3F8 gas into her left eye. At 3 months after surgery, best-corrected visual acuity had improved to 0.8 in her left eye, and the retina was stable.
Notes
This study was presented as a poster at the 119th Annual Metting of the Korean Ophthalmological Society 2018.
References
1. Duke R, Ikpeme A. Primary congenital glaucoma with delayed suprachoroidal hemorrhage following combined trabeculotomy trabeculectomy and 5-fluorouracil. Case Rep Ophthalmol Med. 2015; 2015:163859.
2. Reibaldi M, Longo A, Romano MR, et al. Delayed suprachoroidal hemorrhage after pars plana vitrectomy: five-year results of a retrospective multicenter cohort study. Am J Ophthalmol. 2015; 160:1235–1242.e1.
3. Ghorayeb G, Khan A, Godley BF. Delayed suprachoroidal hemorrhage after cataract surgery. Retin Cases Brief Rep. 2012; 6:390–392.
4. Sharma T, Virdi DS, Parikh S, et al. A case-control study of suprachoroidal hemorrhage during pars plana vitrectomy. Ophthalmic Surg Lasers. 1997; 28:640–644.
5. Lim HW, Ko BW, Song Y, Lee BR. Suprachoroidal hemorrhage during pars plana vitrectomy associated with valsalva maneuver. J Korean Ophthalmol Soc. 2008; 49:1022–1027.
6. Yi R, Ohn K, Roh YJ, et al. A case of resolved massive suprachoroidal hemorrhage after sclerotomy in penetrating keratoplasty patient. J Korean Ophthalmol Soc. 2017; 58:1106–1109.
7. Zauberman H. Expulsive choroidal haemorrhage: an experimental study. Br J Ophthalmol. 1982; 66:43–45.
8. Maumenee AE, Schwartz MF. Acute intraoperative choroidal effusion. Am J Ophthalmol. 1985; 100:147–154.
9. Brown P, Chignell AH. Accidental drainage of subretinal fluid. Br J Ophthalmol. 1982; 66:625–626.
10. Tuli SS, WuDunn D, Ciulla TA, Cantor LB. Delayed suprachoroidal hemorrhage after glaucoma filtration procedures. Ophthalmology. 2001; 108:1808–1811.
11. Pederson JE. Experimental retinal detachment. IV. aqueous humor dynamics in rhegmatogenous detachments. Arch Ophthalmol. 1982; 100:1814–1816.
12. Piper JG, Han DP, Abrams GW, Mieler WF. Perioperative choroidal hemorrhage at pars plana vitrectomy. A case-control study. Ophthalmology. 1993; 100:699–704.
13. Han JI, Cho SW, Lee TG, et al. The clinical results of sutureless vitrectomy using 23-gauge surgical system. J Korean Ophthalmol Soc. 2008; 49:911–916.
14. Chu TG, Cano MR, Green RL, et al. Massive suprachoroidal hemorrhage with central retinal apposition. a clinical and echographic study. Arch Ophthalmol. 1991; 109:1575–1581.