J Korean Ophthalmol Soc.  2018 Nov;59(11):1082-1086. 10.3341/jkos.2018.59.11.1082.

A Case of Suprachoroidal Hemorrhage after Pars Plana Vitrectomy for Rhegmatogenous Retinal Detachment

• Kim MH
• Oh JH

• KMID: 2426371
• DOI: http://doi.org/10.3341/jkos.2018.59.11.1082

Abstract

PURPOSE
To report a case of a 60-year-old female with rhegmatogenous retinal detachment, presenting with suprachoroidal hemorrhage after vitrectomy.
CASE SUMMARY
A 60-year-old woman visited our clinic complaining of floaters, flashing, and blurred vision. Best-corrected visual acuity was 0.1 in her left eye, and fundus examination of her left eye revealed macula-involved retinal detachment with a retinal break at the superotemporal quadrant. She underwent cataract surgery, 23-gauge transconjunctival sutureless vitrectomy, and 14% C3F8 gas tamponade under general anesthesia. One hour after anesthesia recovery, she suddenly complained of severe pain in her left eye. The intraocular pressure measured after removal of the pressure patch from her left eye was as high as 58 mmHg. Her ocular pain improved spontaneously within 10 minutes, and the intraocular pressure decreased to 8 mmHg. Fundus examination of her left eye revealed a reddish-brown raised lesion, suggesting suprachoroidal hemorrhage. She was placed in a prone position with a pressure patch over her left eye. Bleeding through the sclerotomy site was observed 1 day after surgery. Subsequently, hemorrhagic choroidal detachment of her left eye continued to decrease without deterioration. Three weeks after surgery, the patient received an intravitreal injection of 100% C3F8 gas into her left eye. At 3 months after surgery, best-corrected visual acuity had improved to 0.8 in her left eye, and the retina was stable.
CONCLUSIONS
Suprachoroidal hemorrhage may be suspected in a patient complaining of severe ocular pain after vitrectomy.

Keyword

Pars plana vitrectomy; Rhegmatogenous retinal detachment; Suprachoroidal hemorrhage

MeSH Terms

Anesthesia
Anesthesia, General
Cataract
Choroid
Female
Hemorrhage*
Humans
Intraocular Pressure
Intravitreal Injections
Middle Aged
Prone Position
Retina
Retinal Detachment*
Retinal Perforations
Retinaldehyde*
Visual Acuity
Vitrectomy*
Retinaldehyde

Figure

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  Figure 1 Ultra wide field fundus photograph at the initial examination. Note the macula-involved retinal detachment.

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  Figure 2 Choroidal detachment because of postoperative suprachoroidal hemorrhage. Note the reddish-brown raised lesion.

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  Figure 3 Ultra wide field fundus photograph at three weeks after surgery. Decreased suprachoroidal hemorrhage is shown and only a little C3F8 gas remained.

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  Figure 4 Ultra wide field fundus photograph at three months after surgery. Stable condition of the retina is demonstrated.

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