Abstract
Purpose :
To investigate recent visual acuity (VA) outcomes in patients with suprachoroidal hemorrhage (SCH) after surgery, and to identify clinical features associated with visual prognosis.
Methods :
A retrospective case series of 20 eyes from 20 patients diagnosed with SCH after cataract or glaucoma surgery between Jan. 2014 and Oct. 2020. Tabulated variables included age, sex, hypertension, diabetes, anticoagulation status, lens status, previous ocular surgery, surgery type causing SCH, presenting VA, presenting intraocular pressure (IOP), concurrent pathology on presentation (including flat anterior chamber, vitreous hemorrhage, retinal detachment), duration of apposition, management of SCH (observation, primary drainage, or delayed vitrectomy (PPV)), and post-operative outcomes (VA and IOP). The following LogMAR assignments were utilized: counting fingers = 1.9, hand motion = 2.3, light perception = 2.7, and no light perception = 3. OLS and logistic regression analyses were used for continuous and binary variables, respectively.
Results :
The mean patient age was 81 years (SD 13.9), and 14 of 20 eyes were pseudophakic. In the series: 9 cases were post-glaucoma surgery, 7 post-cataract surgery, 4 post-corneal surgery (DSEK or PKP), and 2 from perforated corneal ulcers. SCH developed intraoperatively in 3 cases and post-operatively in 17 cases. The average VA on presentation was 2.45 LogMAR (SD 0.625), and average IOP was 20.1 mmHg (SD 16.9). 10 cases were managed with observation, 9 with delayed PPV, and 1 with delayed drainage. The average post-operative VA was 2.26 LogMAR (SD 0.66) on POD1, and 1.81 LogMAR (SD 0.94) on POM1. Presenting VA was predictive of POD1 (b=0.563, p=0.013) and POM1 VA (b=0.74, p=0.022).
Conclusions :
Findings from this case series suggest that advances in the management of post-operative SCH have led to improved visual outcomes. A similar study performed at our institution 20 years prior showed that only 8/51 (16%) patients achieved 20/200 vision or better, and 14/51 (27.5%) patients had NLP vision after SCH. In this current series, 6/20 (30%) achieved 20/200 vision or better, and only 3/20 patients (15%) had NLP vision after SCH. Although no specific intervention was found to be predictive of better outcomes, further study of additional cases is required for a comprehensive comparison.
This is a 2021 ARVO Annual Meeting abstract.