Cagini Carlo, Iannone Alessia, Bartolini Anna, Fiore Tito, Fierro Tiziana, Gresele Paolo
Department of Surgical and Biomedical Sciences, Division of Ophthalmology, University of Perugia, Perugia - Italy.
Department of Medicine, Division of Internal and Cardiovascular Medicine, University of Perugia, Perugia - Italy.
Eur J Ophthalmol. 2016 Mar-Apr;26(2):188-92. doi: 10.5301/ejo.5000692. Epub 2015 Oct 14.
To evaluate causes of visits to the Eye Emergency Department, determine the prevalence of subconjunctival hemorrhage (SCH), and assess the role of hemostatic abnormalities among patients with spontaneous recurrent SCH (SRSCH).
In a prospective study conducted over 2 years, hemostatic function was studied in a subgroup of 105 consecutive patients (39 male) with SRSCH free of systemic risk factors and in 53 age- and sex-matched healthy controls (HC) (24 male).
A total of 10,090 patients (mean age 57.2 ± 16.7 years, range 0-94, median 58.4) were evaluated. A total of 39.3% had ocular trauma, 34.9% inflammatory ocular surface disorder, 5.7% floaters, 3.3% visual symptoms of neurologic origin, 1.6% uveitis, 1.5% ocular hypertension, 0.8% retinal tear or detachment, 0.7% retinal vascular disease, and 0.5% other causes. A total of 1.6% of the patients were hospitalized. A total of 11.7% of patients had SCH: in 86.7% it was spontaneous, in 13.3% consequent to trauma or to ocular surface disorders. A total of 105 patients had SRSCH, and the prevalence of hemostatic abnormalities among them was not different from HC. Type I von Willebrand disease was diagnosed in 1 patient with SCH and in none of the HC (χ² = 0.13, p = 0.72).
Most patients had ocular infection or trauma and were treated on an outpatient basis; SCH was the third cause of access. The large majority of SCH were unprovoked, and the prevalence of hemostatic alterations in patients with SRSCH and no systemic causes was not different from the general population. Hemostatic screening or second level blood clotting tests were of no use in these patients.
评估眼科急诊科就诊原因，确定结膜下出血（SCH）的患病率，并评估自发性复发性结膜下出血（SRSCH）患者中止血异常的作用。
在一项为期2年的前瞻性研究中，对105例连续的无全身危险因素的SRSCH患者（39例男性）亚组和53例年龄及性别匹配的健康对照者（HC）（24例男性）进行了止血功能研究。
共评估了10090例患者（平均年龄57.2±16.7岁，范围0 - 94岁，中位数58.4岁）。其中39.3%有眼外伤，34.9%有炎性眼表疾病，5.7%有飞蚊症，3.3%有神经源性视觉症状，1.6%有葡萄膜炎，1.5%有高眼压症，0.8%有视网膜裂孔或脱离，0.7%有视网膜血管疾病，0.5%有其他原因。共有1.6%的患者住院。共有11.7%的患者有SCH：其中86.7%为自发性，13.3%因外伤或眼表疾病所致。共有105例患者有SRSCH，他们中止血异常的患病率与HC无差异。1例SCH患者被诊断为Ⅰ型血管性血友病，HC中无1例诊断为此病（χ² = 0.13，p = 0.72）。
大多数患者有眼部感染或外伤，在门诊接受治疗；SCH是就诊的第三大原因。绝大多数SCH是自发性的，无全身病因的SRSCH患者中止血改变的患病率与普通人群无差异。止血筛查或二级凝血试验对这些患者无用。
