Spontaneous suprachoroidal haemorrhage: clinical features, visual outcomes and prognosis factors.
Journal
Eye (London, England)
ISSN: 1476-5454
Titre abrégé: Eye (Lond)
Pays: England
ID NLM: 8703986
Informations de publication
Date de publication:
28 Jul 2024
28 Jul 2024
Historique:
received:
18
10
2023
accepted:
22
07
2024
revised:
17
07
2024
medline:
29
7
2024
pubmed:
29
7
2024
entrez:
28
7
2024
Statut:
aheadofprint
Résumé
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.
Sections du résumé
BACKGROUND
BACKGROUND
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.
METHODS
METHODS
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.
RESULTS
RESULTS
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.
CONCLUSION
CONCLUSIONS
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.
Identifiants
pubmed: 39069552
doi: 10.1038/s41433-024-03278-9
pii: 10.1038/s41433-024-03278-9
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s), under exclusive licence to The Royal College of Ophthalmologists.
Références
Iheonunekwu C, Krasnoschlik NJ, Schramm J, Shundry N, Simon EL. Spontaneous expulsive suprachoroidal hemorrhage. Am J Emerg Med. 2023;70:210.e1–210.e3. https://doi.org/10.1016/j.ajem.2023.06.008 .
doi: 10.1016/j.ajem.2023.06.008
pubmed: 37349235
Mohan S, Sadeghi E, Mohan M, Iannetta D, Chhablani J. Suprachoroidal hemorrhage. Ophthalmologica. 2023;246:255–77. https://doi.org/10.1159/000533937 .
doi: 10.1159/000533937
pubmed: 37660688
Payne JW, Kameen AJ, Jensen AD, Christy NE. Expulsive hemorrhage: its incidence in cataract surgery and a report of four bilateral cases. Trans Am Ophthalmol Soc. 1985;83:181–204.
pubmed: 3832526
pmcid: 1298696
Savastano A, Rizzo S, Savastano MC, Piccirillo V, Forte R, Sbordone S, et al. Choroidal effusion and suprachoroidal hemorrhage during phacoemulsification: intraoperative management to prevent expulsive hemorrhage. Eur J Ophthalmol. 2016;26:338–41. https://doi.org/10.5301/ejo.5000707 .
doi: 10.5301/ejo.5000707
pubmed: 26559935
Vaziri K, Schwartz SG, Kishor KS, Fortun JA, Moshfeghi DM, Moshfeghi AA, et al. Incidence of postoperative suprachoroidal hemorrhage after glaucoma filtration surgeries in the United States. Clin Ophthalmol. 2015;9:579–84. https://doi.org/10.2147/OPTH.S78359 .
doi: 10.2147/OPTH.S78359
pubmed: 25897196
pmcid: 4396511
Chandra A, Xing W, Kadhim MR, Williamson TH. Suprachoroidal hemorrhage in pars plana vitrectomy: risk factors and outcomes over 10 years. Ophthalmology. 2014;121:311–7. https://doi.org/10.1016/j.ophtha.2013.06.021 .
doi: 10.1016/j.ophtha.2013.06.021
pubmed: 23870800
Chu TG, Green RL. Suprachoroidal hemorrhage. Surv Ophthalmol. 1999;43:471–86. https://doi.org/10.1016/s0039-6257(99)00037-5 .
doi: 10.1016/s0039-6257(99)00037-5
pubmed: 10416790
Chai F, Zeng L, Li C, Zhao X. Spontaneous suprachoroidal hemorrhage in a high myopia patient with rhegmatogenous retinal detachment: a case report and literature review. Biosci Rep. 2019;39:BSR20181454. https://doi.org/10.1042/BSR20181454 .
doi: 10.1042/BSR20181454
pubmed: 31160485
pmcid: 6591562
Collon S, Teske M, Simonett J. Bilateral Spontaneous Suprachoroidal Hemorrhage after Systemic Tissue Plasminogen Activator. Ophthalmol Retin. 2022;6:519. https://doi.org/10.1016/j.oret.2022.03.023 .
doi: 10.1016/j.oret.2022.03.023
Barsam A, Heatley CJ, Herbert L. Spontaneous suprachoroidal hemorrhage secondary to thrombolysis for the treatment of myocardial infarction. Clin Exp Ophthalmol. 2006;34:177–9. https://doi.org/10.1111/j.1442-9071.2006.01149.x .
doi: 10.1111/j.1442-9071.2006.01149.x
pubmed: 16626438
Chen YY, Chen YY, Sheu SJ. Spontaneous suprachoroidal hemorrhage associated with age-related macular degeneration and anticoagulation therapy. J Chin Med Assoc. 2009;72:385–7. https://doi.org/10.1016/S1726-4901(09)70393-4 .
doi: 10.1016/S1726-4901(09)70393-4
pubmed: 19581147
Alexandrakis G, Chaudhry NA, Liggett PE, Weitzman M. Spontaneous suprachoroidal hemorrhage in age-related macular degeneration presenting as angle-closure glaucoma. Retina. 1998;18:485–6. https://doi.org/10.1097/00006982-199805000-00023 .
doi: 10.1097/00006982-199805000-00023
pubmed: 9801053
Goldsmith C, Rene C. Massive spontaneous expulsive suprachoroidal haemorrhage in a blind glaucomatous eye treated with chronic topical steroid. Eye. 2003;17:439–40. https://doi.org/10.1038/sj.eye.6700372 .
doi: 10.1038/sj.eye.6700372
pubmed: 12724718
Chak M, Williamson TH. Spontaneous suprachoroidal haemorrhage associated with high myopia and aspirin. Eye. 2003;17:525–7. https://doi.org/10.1038/sj.eye.6700388 .
doi: 10.1038/sj.eye.6700388
pubmed: 12802356
Manschot WA. The pathology of expulsive hemorrhage. Am J Ophthalmol. 1955;40:15–24.
doi: 10.1016/0002-9394(55)92116-4
pubmed: 14388089
Maumenee AE, Schwartz MF. Acute intraoperative choroidal effusion. Am J Ophthalmol. 1985;100:147–54. https://doi.org/10.1016/s0002-9394(14)74997-9 .
doi: 10.1016/s0002-9394(14)74997-9
pubmed: 3893137
Lakhanpal V. Experimental and clinical observations on massive suprachoroidal hemorrhage. Trans Am Ophthalmol Soc. 1993;91:545–652.
pubmed: 8140705
pmcid: 1298482
Hsiao SF, Shih MH, Huang FC. Spontaneous suprachoroidal hemorrhage: Case report and review of the literature. Taiwan J Ophthalmol. 2016;6:36–41. https://doi.org/10.1016/j.tjo.2014.10.008 .
doi: 10.1016/j.tjo.2014.10.008
pubmed: 29018708
Masri I, Smith JM, Wride NK, Ghosh S. A rare case of acute angle closure due to spontaneous suprachoroidal haemorrhage secondary to loss of anti-coagulation control: a case report. BMC Ophthalmol. 2018;18:224 https://doi.org/10.1186/s12886-018-0857-4 .
doi: 10.1186/s12886-018-0857-4
pubmed: 30255796
pmcid: 6157128
Yang SS, Fu AD, McDonald HR, Johnson RN, Ai E, Jumper JM. Massive spontaneous choroidal hemorrhage. Retina. 2003;23:139–44. https://doi.org/10.1097/00006982-200304000-00001 .
doi: 10.1097/00006982-200304000-00001
pubmed: 12707590
Meier P, Wiedemann P. Massive suprachoroidal hemorrhage: secondary treatment and outcome. Graefes Arch Clin Exp Ophthalmol. 2000;238:28–32. https://doi.org/10.1007/s004170050005 .
doi: 10.1007/s004170050005
pubmed: 10664049
Scott IU, Flynn HW Jr, Schiffman J, Smiddy WE, Murray TG, Ehlies F. Visual acuity outcomes among patients with appositional suprachoroidal hemorrhage. Ophthalmology. 1997;104:2039–46. https://doi.org/10.1016/s0161-6420(97)30042-6 .
doi: 10.1016/s0161-6420(97)30042-6
pubmed: 9400763