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Title:

Subhyaloid haemorrhage following retinal vein occlusion


Poster Details

First Author: S. Neary IRELAND

Co Author(s):    K. Kennelly                    

Abstract Details

Purpose:

Subhyaloid macular haemorrhage is a rare complication following retinal vein occlusion.

Setting:

Case report.

Methods:

A 53 year old lady presented with acute loss of vision on waking in the left eye. Her ophthalmic history was significant for right anisemetropic ambylopia, hyperopia and presbyopia and she was an ex-smoker of 13 years. On examination, vision was right 6/38 and left 6/15. Intraocular pressures were right 16 mmHg and left 12 mmHg. Pupillary responses and anterior segment exam was normal in both eyes. Dilated fundus exam of the left eye revealed a posterior vitreous detachment, a fresh appearing subhyaloid haemorrhage at the inferior macula and evidence of a superior branch retinal vein occlusion with retinal neovascularisation.

Results:

Blood pressure on presentation was elevated at 160/87 mmHg. Systemic laboratory investigations were all normal. Fundus fluorescein angiogram revealed delayed filling of the occluded retinal vein and areas of capillary nonperfusion and leakage at areas of neovasculatisation. Ischaemic retina was treated with sectoral panretinal photocoagulation. The subhyaloid haemorrhage was observed and resolved.

Conclusions:

Subhyaloid macular haemorrhage is a rare complication of retinal vein occlusion. A Valsalva's manoeuver or posterior vitreous detachment could have caused subhyaloid haemorrhage from a nidus of retinal neovascularisation in our patient. Hayreh et al in his study on fundus changes in central retinal vein occlusion showed higher propensity of sub-ILM and subhyaloid haemorrhages in ischaemic as compared to non-ischaemic central retinal vein occlusion. Other causes of subhyaloid haemorrhage include vascular malformations, Terson's syndrome, trauma or Valsalva's manoeuver.

Financial Disclosure:

None




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