Suprachoroidal hemorrhage associated with pars plana vitrectomy

Purpose To analyze the characteristics, related risk factors, and prognosis of suprachoroidal hemorrhage (SCH) associated with pars plana vitrectomy (PPV). Methods Cases of SCH associated with PPV excluding trauma were retrospectively analyzed in Beijing Tongren Hospital between January 2010 and June 2020. The data collected included general data, myopia status, axial length, state of the crystalline lens, SCH onset time, range, treatment method, visual prognosis, and methods of operation and anesthesia. Patients were divided into those with SCH related to the first PPV (Group 1), and SCH related to second intraocular surgery in the vitrectomized eye (Group 2). Patients were also classified by the SCH onset time into either the expulsive suprachoroidal hemorrhage group (ESCH) and the delayed suprachoroidal hemorrhage group (DSCH). The general data, related risk factors, and the visual prognosis of SCH in the different groups were analyzed. Results SCH associated with PPV was studied in 28 cases with an incidence of 0.06 %; 16 males and 12 females. The mean age of the patients was (53.51 ± 10.21) years old, the mean follow-up time was (24.94 ± 14.60) days, and the mean axial length was (28.21 ± 3.14) mm. Of these cases, 21 were classified as high myopia, 25 as aphakia/ pseudophakic, and 7 as focal hemorrhage. Silicone oil removal occurred in 12 cases (43 %). Patients in Group 2 were younger than Group 1 (P = 0.005). In terms of treatment and prognosis, 5 eyes were simply closely observed, 4 were given single suprachoroidal drainage, 15 were given suprachoroidal drainage combined with silicone tamponade, 2 underwent anterior chamber puncture, and 2 gave up treatment. A follow-up vision: NLP ~ 20/30; among them, 2 eyes with NLP (7.14 %), 6 of ≥ 20/200 (21.43 %). The final outcomes presented a significantly positive correlation with baseline vision but no significant correlation with age or axial length. Conclusions SCH has a higher incidence rate after a second intraocular surgery in a vitrectomized eye which is associated with the lack of vitreous support and easier fluctuation of intraocular pressure. SCH associated with PPV is more localized and has a relatively good prognosis; high myopia and aphakic/ pseudophakic eyes are risk factors. Active treatment can effectively improve visual prognosis. Trial registration Retrospective case series study, not applicable.

Suprachoroidal hemorrhage associated with pars plana vitrectomy

Purpose To analyze the characteristics, related risk factors, and prognosis of suprachoroidal hemorrhage (SCH) associated with pars plana vitrectomy (PPV). Methods Cases of SCH associated with PPV excluding trauma were retrospectively analyzed in Beijing Tongren Hospital between January 2010 and June 2020. General data were collected including general data, myopia status, axial length, state of crystalline lens, onset time of SCH, range, treatment method, visual prognosis, and methods of operation and anesthesia. Patients were divided into those with SCH related to first PPV (Group 1), and SCH related to second intraocular surgery in vitrectomized eye (Group 2). Patients were also categorized by the onset time of SCH as expulsive suprachoroidal hemorrhage group (ESCH), and delayed suprachoroidal hemorrhage group (DSCH).The general data, related risk factors, and the visual prognosis of SCH in different groups were analyzed. Results SCH associated with PPV was studied in 28 cases; 16 male and 12 female. The mean age of the patients was (53.51 ± 10.21) years old, and the mean follow-up time (24.94 ± 14.60) days, mean axial length was (28.21 ± 3.14) mm. Of these cases, 21 was high myopia, 25 was aphakia/ pseudophakic, and 7 had focal hemorrhage. Silicone oil removal had the highest occurrence with 12 cases (43%). Patients in Group 2 were younger than Group 1 (P = 0.005). In terms of treatment and prognosis, 5 eyes were simply closely observed, 4 given single suprachoroidal drainage, 15 given suprachoroidal drainage combining silicone tamponade, 2 undergoing anterior chamber puncture, and 2 giving up treatment. A follow-up vision: NLP ~ 20/30; 2 eyes with NLP (7.14%), 6 of ≥ 20/200 (21.43%). The final outcomes presented a significantly positive correlation with baseline vision, but no significant correlation with age or axial length. Conclusions SCH has a higher incidence rate after a second intraocular surgery in a vitrectomized eye which is associated with the lack of vitreous support and easier fluctuation of intraocular pressure. SCH associated with PPV is more localized and has a relatively good prognosis; high myopia and aphakic/ pseudophakic eyes are risk factors. Active treatment can effectively improve visual prognosis. Trial registration: Retrospective case series study, not applicable.