Abstract
Purpose :
To describe and analyze the clinical features and management of suprachoroidal hemorrhage (SCH) in different settings and identify any prognostic factors associated with visual outcomes.
Methods :
This was a single-center retrospective case series of consecutive eyes with SCH that were treated between March 2014 and December 2022 at the Wills Eye Hospital and the offices of Mid Atlantic Retina. The main outcome measures included final visual outcomes and factors associated with visual outcomes.
Results :
Forty-two eyes of 40 patients with SCH were evaluated. The mean age was 70.0 years. The median follow-up length was 595 days. The inciting events of SCH included ocular surgeries in 55% (23/42 eyes) (13 pars plana vitrectomy [PPV], 4 tube shunts, 3 cataract surgeries, 1 trabeculectomy, 1 scleral buckle, and 1 penetrating keratoplasty), trauma in 31% (13/42) (11 penetrating and 2 blunt), and spontaneous occurrence in 14% (6/42). The SCHs were appositional in 6 eyes and concurrent retinal detachments were observed in 10 eyes. Overall, 57% (24/42) were managed surgically (17 PPV and external drainage, 7 external drainage alone) and 43% (18/42) were observed. In 24 eyes that were treated surgically, 17% (4/24) were drained within 3 days of presentation, 46% (11/24) were drained 4-14 days after presentation, and 38% (9/24) were drained >14 days. 50% (2/4) of SCH drained within 3 days required a follow-up surgery compared with 18% (2/11) of SCH drained within 4 -14 days and 22% (2/9) of SCH drained after 14 days. The logarithm of the minimum angle of resolution (logMAR) visual acuity significantly improved from 2.28±0.63 (Snellen equivalent, 20/3811) at baseline to 1.94±0.92 (20/1742) at the final visit (P=0.007). However, ten eyes were non-light perception and one eye resulted in phthisis bulbi at the final follow-up. Multivariable regression analysis revealed that worse baseline visual acuity and traumatic SCH were significantly associated with worse final visual outcomes (P<0.001 and P=0.006, respectively). The surgical techniques for drainage and time to drainage were not associated with visual outcomes.
Conclusions :
In SCH, especially those associated with trauma, it remains challenging to maintain vision, regardless of the surgical techniques and timing of surgery.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.