Suprachoroidal hemorrhage: Outcome of surgical management according to hemorrhage severity

William J. Wirostko, Dennis P. Han, William F. Mieler, Jose S Pulido, Thomas B. Connor, Evelyn Kuhn

Research output: Contribution to journalArticle

42 Citations (Scopus)

Abstract

Objective: To report the visual and anatomic outcome after surgical drainage of suprachoroidal hemorrhage according to hemorrhage severity. Design: A retrospective chart review. Participants: Forty-eight consecutive eyes undergoing surgical drainage of a suprachoroidal hemorrhage at The Medical College of Wisconsin were examined. Intervention: Demographic and clinical data were abstracted from patients, medical records. Eyes were classified into four categories of increasing hemorrhage complexity: (1) nonappositional choroidal hemorrhage without vitreous or retinal incarceration in the wound (12 eyes); (2) centrally appositional choroidal hemorrhage without vitreous or retinal incarceration in the wound (17 eyes); (3) choroidal hemorrhage with associated vitreous incarceration in the wound (11 eyes); and (4) choroidal hemorrhage with associated retinal incarceration in the wound (8 eyes). Main Outcome Measures: Visual acuity, rate of persistent hypotony, and incidence of irreparable retinal detachment after surgical drainage for four classes of suprachoroidal hemorrhage were defined. Results: Overall, 11 (23%) of 48 eyes had no light perception (NLP) vision develop, 9 (19%) of 48 eyes had persistent postsurgical hypotony (intraocular pressure <6), and 21 (64%) of 33 eyes with retinal detachment enjoyed successful retinal reattachment surgery. A definite trend toward an increased rate of NLP vision (P <0.02), persistent hypotony (P <0.05), and irreparable retinal detachment (P = 0.11) was observed with increasing suprachoroidal hemorrhage complexity. Eyes with retinal incarceration, compared to eyes without retinal incarceration, had an increased rate of NLP vision (63% vs. 15%; P <0.01), persistent postsurgical hypotony (50% vs. 13%; P <0.05), and irreparable retinal detachment (50% vs. 20%; P = 0.07). Conclusions: Eyes requiring surgical drainage of a suprachoroidal hemorrhage have a guarded prognosis, with a poorer outcome associated with increasing hemorrhage complexity. A classification system incorporating choroidal apposition, and vitreous and retinal incarceration in the wound, provides a format for reporting and assessing the efficacy of management strategies in this condition.

Original languageEnglish (US)
Pages (from-to)2271-2275
Number of pages5
JournalOphthalmology
Volume105
Issue number12
StatePublished - Dec 1 1998
Externally publishedYes

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Surgical Blood Loss
Hemorrhage
Choroid Hemorrhage
Retinal Detachment
Drainage
Wounds and Injuries
Intraocular Pressure
Visual Acuity
Medical Records

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Wirostko, W. J., Han, D. P., Mieler, W. F., Pulido, J. S., Connor, T. B., & Kuhn, E. (1998). Suprachoroidal hemorrhage: Outcome of surgical management according to hemorrhage severity. Ophthalmology, 105(12), 2271-2275.

Suprachoroidal hemorrhage : Outcome of surgical management according to hemorrhage severity. / Wirostko, William J.; Han, Dennis P.; Mieler, William F.; Pulido, Jose S; Connor, Thomas B.; Kuhn, Evelyn.

In: Ophthalmology, Vol. 105, No. 12, 01.12.1998, p. 2271-2275.

Research output: Contribution to journalArticle

Wirostko, WJ, Han, DP, Mieler, WF, Pulido, JS, Connor, TB & Kuhn, E 1998, 'Suprachoroidal hemorrhage: Outcome of surgical management according to hemorrhage severity', Ophthalmology, vol. 105, no. 12, pp. 2271-2275.
Wirostko WJ, Han DP, Mieler WF, Pulido JS, Connor TB, Kuhn E. Suprachoroidal hemorrhage: Outcome of surgical management according to hemorrhage severity. Ophthalmology. 1998 Dec 1;105(12):2271-2275.
Wirostko, William J. ; Han, Dennis P. ; Mieler, William F. ; Pulido, Jose S ; Connor, Thomas B. ; Kuhn, Evelyn. / Suprachoroidal hemorrhage : Outcome of surgical management according to hemorrhage severity. In: Ophthalmology. 1998 ; Vol. 105, No. 12. pp. 2271-2275.
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abstract = "Objective: To report the visual and anatomic outcome after surgical drainage of suprachoroidal hemorrhage according to hemorrhage severity. Design: A retrospective chart review. Participants: Forty-eight consecutive eyes undergoing surgical drainage of a suprachoroidal hemorrhage at The Medical College of Wisconsin were examined. Intervention: Demographic and clinical data were abstracted from patients, medical records. Eyes were classified into four categories of increasing hemorrhage complexity: (1) nonappositional choroidal hemorrhage without vitreous or retinal incarceration in the wound (12 eyes); (2) centrally appositional choroidal hemorrhage without vitreous or retinal incarceration in the wound (17 eyes); (3) choroidal hemorrhage with associated vitreous incarceration in the wound (11 eyes); and (4) choroidal hemorrhage with associated retinal incarceration in the wound (8 eyes). Main Outcome Measures: Visual acuity, rate of persistent hypotony, and incidence of irreparable retinal detachment after surgical drainage for four classes of suprachoroidal hemorrhage were defined. Results: Overall, 11 (23{\%}) of 48 eyes had no light perception (NLP) vision develop, 9 (19{\%}) of 48 eyes had persistent postsurgical hypotony (intraocular pressure <6), and 21 (64{\%}) of 33 eyes with retinal detachment enjoyed successful retinal reattachment surgery. A definite trend toward an increased rate of NLP vision (P <0.02), persistent hypotony (P <0.05), and irreparable retinal detachment (P = 0.11) was observed with increasing suprachoroidal hemorrhage complexity. Eyes with retinal incarceration, compared to eyes without retinal incarceration, had an increased rate of NLP vision (63{\%} vs. 15{\%}; P <0.01), persistent postsurgical hypotony (50{\%} vs. 13{\%}; P <0.05), and irreparable retinal detachment (50{\%} vs. 20{\%}; P = 0.07). Conclusions: Eyes requiring surgical drainage of a suprachoroidal hemorrhage have a guarded prognosis, with a poorer outcome associated with increasing hemorrhage complexity. A classification system incorporating choroidal apposition, and vitreous and retinal incarceration in the wound, provides a format for reporting and assessing the efficacy of management strategies in this condition.",
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