Massive Spontaneous Choroidal Hemorrhage

Abstract

Massive spontaneous choroidal hemorrhage may be associated with hypertension, systemic anticoagulation, advanced age, and age-related macular degeneration. Final visual acuities are generally poor.

Ocular Bleeding Related to Warfarin Anticoagulation in Patients with Mechanical Heart Valve and Atrial Fibrillation

“…13 Our results show that hypertension and advanced age might lead to ocular haemorrhage in patients receiving warfarin therapy, and that warfarin therapy should be considered as a risk factor for ocular bleeding. 10,14 In the present study we were not able to find any statistically significant association between ocular bleeding and gender, INR within the therapeutic range, the duration of warfarin therapy, the presence of diabetes 7 pointed out that aspirin therapy might double the risk of bleeding in patients taking warfarin. A recent large study by Shireman et al 15 reported that the risk of bleeding was moderately increased in elderly patients receiving combined warfarin and antiplatelet therapy.…”

“…Previous studies have shown that the incidence of retinal bleeding might increase with the presence of hypertension and advanced age. 7,9 In a recent study, Yang et al 10 showed that ocular bleeding, especially massive spontaneous choroidal haemorrhage, might be associated with hypertension, advanced age, systemic anticoagulation, atherosclerosis and agerelated macular degeneration. Our data are therefore consistent with previously reported research.…”

Polypoidal choroidal vasculopathy causing massive suprachoroidal haemorrhage

“…[1][2][3][4]7 Our patient, who presented in an advanced stage of visual loss, had a recurrent suprachoroidal bleed but was eventually free of pain and was therefore managed conservatively.…”

“…[1][2][3] Although PCV may cause subretinal haemorrhage, the authors are unaware of any previous reports on PCV causing massive and rapid suprachoroidal haemorrhage leading to secondary angle closure glaucoma. This may be because the diagnosis of PCV has increased in recent years with the advent of ICG angiography.…”

“…It is believed that shearing forces acting on blood vessels as they enter the suprachoroidal space rupture the vessels and cause suprachoroidal haemorrhage. 3 Systemic risk factors such as advanced age, hypertension, and arteriolosclerosis increase fragility of these vessels and hence their susceptibility to mechanical shearing forces, such as a valsalva manoeuvre. Our patient did not have any known predisposing factors for a suprachoroidal bleed F she was not taking anticoagulants, and was not straining or coughing at the time the massive suprachoroidal haemorrhage occurred.…”