SUPRACHOROIDAL HEMORRHAGE - CLINICAL-FEATURES AND RESULTS OF SECONDARY SURGICAL-MANAGEMENT

Purpose: The purposes of this study are to identify clinical features in eyes with suprachoroidal hemorrhage which portend a poor visual pro gnosis and to determine visual outcome in these eyes after secondary s urgical management of suprachoroidal hemorrhage. Methods: This was a r etrospective study of 106 patients with suprachoroidal hemorrhages occ urring in association with trauma (35), cataract surgery (30), glaucom a surgery (1 7), penetrating keratoplasty (6), corneal perforation (5) , secondary lens implantation (3), pars plana vitrectomy (3), and othe r causes (7). Results: Five (10%) of 49 eyes with a suprachoroidal hem orrhage and an initial retinal detachment had a visual outcome of 20/2 00 or better compared with 21 (43%) of 49 eyes without a retinal detac hment. The presence or absence of a retinal detachment could not be de termined in eight patients and all eight of these patients had a poor visual outcome. Sixteen (20%) of 82 eyes with a 360-degrees suprachoro idal hemorrhage had a visual outcome of 20/200 or better compared with 10 (47%) of 21 for those with suprachoroidal hemorrhage limited to on e or two quadrants. The extent of the hemorrhage could not be determin ed in three eyes. Overall, 34% (14/41) of the patients with suprachoro idal hemorrhage who had a secondary surgical procedure achieved a visu al outcome of 20/200 or better. Forty-three percent (6/14) who had a s uprachoroidal hemorrhage during or after cataract surgery and who were treated with secondary surgical management achieved a visual outcome of 20/200 or greater. Conclusion: Clinical features associated with a poorer visual outcome included initial or indeterminate retinal detach ment and 360-degrees suprachoroidal hemorrhage. Limited suprachoroidal hemorrhage without initial retinal detachment usually has a good visu al prognosis and does not usually require secondary surgical intervent ion. However, if the former complication is present, secondary surgica l intervention should be considered.