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Mitchell Garrison Nash, Atalie C. Thompson, Clayton Wisely, Eric Attila Postel, Leon Herndon; Risk Factors for Suprachoroidal Hemorrhage and Their Relationship to Morbidity and Mortality. Invest. Ophthalmol. Vis. Sci. 2020;61(7):3161.
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The purpose of this study was 1) to investigate the prevalence of acute (intraoperative) and delayed (postoperative) suprachoroidal hemorrhages (SCH), 2) to examine risk factors for delayed and acute SCH, and 3) to describe the relationship between SCH and mortality.
Retrospective review of all SCH cases diagnosed at the Duke Eye Center between July 1, 2013 and July 1, 2018 with at least one month of follow-up was conducted. Demographic information, smoking status, comorbidities, medications, type of surgical intervention, SCH timing (acute vs delayed), visual acuity, patient mortality, and time to mortality were reviewed.
A total of 77 patients were included with 56/77 SCH occurring intra- (17/56) or postoperatively (39/56), 13/77 were post-traumatic, and 8/77 were spontaneous. Glaucoma surgery was more commonly associated with SCH (38/56) than other types of surgery. 12.5% (2/16) of acute-SCH and 10.8% (4/37) of delayed-SCH patients died by the end of the study. Mean days of survival after SCH was 787.9 (s.d. 626). There was no significant difference in mortality between acute and delayed groups (p=0.86). Patients on anticoagulant medicines at time of surgery did have increased incidence mortality compared to patients not on anticoagulants (p=0.031), while patients on antiplatelets (p=0.73) or NSAIDs (p=0.68) at time of surgery did not correspond with increased incidence of mortality. Patients with SCH with a history of smoking or congestive heart failure had an increased incidence of mortality (p = 0.004 and p=0.063, respectively). Patients in the delayed group had slightly lower logMAR visual acuity (mean = 1.85, s.d. 1.56) at their last follow-up than those in the acute group (mean = 2.51, s.d. 1.72) (p = 0.18). SCH was more often delayed in glaucoma surgery (87%) compared to other surgeries (27%) (p < 0.001).
Delayed SCH was more prevalent than acute SCH. SCH was most commonly associated with glaucoma surgery and tended to be delayed in glaucoma surgery cases. Risk factors associated with increased mortality included use of anticoagulants and history of smoking. No difference was found in mortality in acute vs. delayed SCH.
This is a 2020 ARVO Annual Meeting abstract.
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