Suprachoroidal Hemorrhage

60.1General Considerations1

60.1.1 Indications for Surgery

This arterial bleeding is sight-threatening if it occurs intraoperatively (ECH; see Sect. 40.1). If a limited amount of blood is present in the suprachoroidal space, the first question to answer is whether surgical intervention is necessary at all. Drainage (and PPV) should be considered in the following conditions:

•“Kissing” choroidals: the hemorrhage involves opposing quadrants, and they are so high that there is retina-to-retina touch (see below and Fig. 60.1).

Pearl

If surgery is not performed early after retina-to-retina touch developed, the adhesion between the two surfaces can quickly become so strong that they are inseparable.

•High and medically uncontrollable IOP, with or without severe pain.2

•Breakthrough hemorrhage: with blood in the vitreous, it is impossible to visualize the retina.

•Suprachoroidal blood involving the submacular area.

•Anterior displacement of the retina, with possible lens touch.

•Retinal detachment.

1This chapter is dedicated to the management of suprachoroidal hemorrhage in its chronic phase.

2As the ciliary nerves can be stretched by the solid mass, intolerable pain may be present even in lack of high IOP.

F. Kuhn, Vitreoretinal Surgery: Strategies and Tactics,

DOI 10.1007/978-3-319-19479-0_60