Spontaneous resolution of massive expulsive suprachoroidal hemorrhage with good long-term visual outcome: a case report

• Main Authors: Lee SJ, Lee JH, Park SW, Kim M, Han SB
• Format: Article
• Language: English
• Published: Dove Medical Press 2015-09-01
• Series: International Medical Case Reports Journal
• Online Access: https://www.dovepress.com/spontaneous-resolution-of-massive-expulsive-suprachoroidal-hemorrhage--peer-reviewed-article-IMCRJ

Seung-Jun Lee,* Jang Hun Lee,* Sang Wook Park, Moosang Kim, Sang Beom HanDepartment of Ophthalmology, Kangwon National University Hospital, Kangwon National University Graduate School of Medicine, Chuncheon, Korea*These authors contributed equally to this workIntroduction: Massive suprachoroidal hemorrhage (SCH) that completely fills the vitreous cavity rarely resolves spontaneously. Even in cases with spontaneous resolution, long-term visual prognosis is disappointing due to retinal detachment or deterioration of preexisting ocular diseases. To the best of our knowledge, the first case of spontaneous resolution of massive SCH is reported with good long-term visual and anatomic outcome. Case presentation: An 80-year-old Asian woman with high myopia underwent cataract surgery in the right eye. Posterior capsular rupture occurred during phacoemulsification. At the conclusion of scleral fixation of intraocular lens, expulsive SCH developed. After 1 day, best-corrected visual acuity (BCVA) was hand motion. Ultrasonography revealed massive SCH with central apposition. At 2nd week, decrease in SCH with resolution of central apposition was observed. At 6th week, BCVA improved to 20/120. Ultrasonography and fundus examination revealed complete resorption of the SCH and flat retina. At 1 year, BCVA was 20/50. Fundus was flat without any signs of retinal detachment. Conclusion: Favorable anatomic and visual outcomes can be attained with conservative management even in cases of massive expulsive SCH, particularly when central retinal apposition resolves in 2 weeks.Keywords: conservative management, suprachoroidal hemorrhage, spontaneous resolution