SPONTANEOUS AND TRAUMATIC VITREOUS HEMORRHAGE

Purpose: The authors sought to provide relevant data regarding the dem ographic and clinical aspects of spontaneous and traumatic vitreous he morrhages to guide clinicians in better delineating the expected etiol ogic patterns of these hemorrhages in an urban environment. Methods: T he records of 253 consecutive patients with newly diagnosed vitreous h emorrhage seen in a general eye clinic were selected for retrospective analysis. To minimize selection bias of a tertiary care center, patie nts who were referred to the clinic by outside ophthalmologists for vi treoretinal consultation or those with a history of recent intraocular surgery, postoperative complications, or loss to follow-up were exclu ded from study. Demographic, ocular, and general medical variables wer e tabulated for the 200 patients (230 eyes) who met our inclusion crit eria. Results: Fifty percent of the patients were black, 26% were whit e, 23% were Hispanic, and 1% was Oriental. The causes of vitreous hemo rrhage were proliferative diabetic retinopathy (PDR) (35.2%), trauma ( 18.3%), retinal vein occlusion (7.4%), retinal tear without a detachme nt (7.0%), posterior vitreous detachment (6.5%), proliferative sickle retinopathy (5.7%), retinal tear with a detachment (4.8%), subretinal neovascularization from macular degeneration (2.2%), hypertensive reti nopathy (1.7%), unknown (2.5%), and other causes (8.7%). Among black p atients with spontaneous vitreous hemorrhage, sickle cell retinopathy and retinal vein occlusion were major causes, each accounting for more than 15% of the cases. Systemic hypertension was associated with vitr eous hemorrhage from retinal vein occlusion. Conclusion: The authors p ropose that despite the wide array of causative factors of vitreous he morrhage, the evaluation of demographic, ocular, and medical variables can significantly aid clinicians in identifying its etiologic pattern s.