Early controlled drainage of massive suprachoroidal hemorrhage with the aid of an expanding gas bubble and risk factors.

ABSTRACT

PURPOSE: To assess the visual outcome after massive suprachoroidal hemorrhage managed by early controlled drainage using the aid of an intravitreal expanding gas bubble (100% perfluoropropane). The ocular and systemic risk factors were also reviewed. METHODS: Data were obtained retrospectively from patients with massive suprachoroidal hemorrhage who were treated in Worthing and Southlands National Health Service Trust between January 2003 and December 2008. RESULTS: The study included 10 patients (5 women and 5 men) with a mean age of 73.9 years (range, 54-84 years). All patients underwent early controlled drainage of massive suprachoroidal hemorrhage using 100% perfluoropropane as a tamponade. The mean interval of drainage from the onset was 3.5 days (range, 1-10 days). Anatomical restoration of ocular structures was achieved in 7 patients, with good final visual outcome at mean 9 months (range, 6-14 months). The remaining three patients had poor visual outcome because of retinal detachment with proliferative vitreoretinopathy. The most common risk factor in this case series was glaucoma, which was seen in five patients. Arteriosclerosis was the only risk factor in two patients. CONCLUSION: Early controlled drainage of massive suprachoroidal hemorrhage with 100% perfluoropropane tamponade may help in achieving a good visual outcome. The use of 100% perfluoropropane has the advantage of maintaining positive pressure while facilitating controlled drainage of the hemorrhage as the clot lyses. Retinal detachment however is a poor prognostic indicator. Arteriosclerosis and glaucoma were the most common risk factors seen in this case series.