Rezapour Jasmin, Hoffmann Esther M, Prokosch-Willing Verena, Gericke Adrian, Pfeiffer Norbert
Department of Ophthalmology, University Medical Center Mainz, Mainz, Germany.
J Glaucoma. 2017 Dec;26(12):e268-e270. doi: 10.1097/IJG.0000000000000801.
Suprachoroidal hemorrhage (SCH) is a rare, but potentially vision-threatening event with poor long-term visual prognosis. At present, there is disagreement whether surgical intervention or conservative treatment is superior in the management. We report on a case of spontaneous resolution of severe SCH after needling procedure in the only eye of a young patient with congenital glaucoma.
A 43-year-old woman with congenital glaucoma was scheduled for bleb needling in her only eye. Preoperative best-corrected visual acuity was 20/40 and intraocular pressure 20 mm Hg. On the third postoperative day, she developed a massive delayed SCH with appositional (kissing) choroidal bullae and visual acuity was hand motion. Scleral drainage was performed after 10 days, but did not show a significant decrease of the choroidal swelling and further conservative treatment was discussed. After 2 months, choroidal swelling had completely resolved, best-corrected visual acuity was 20/50, and intraocular pressure was 11 mm Hg.
Full functional recovery and decrease of choroidal swelling may be attained with a conservative treatment of massive delayed SCH after needling procedure in congenital glaucoma.
脉络膜上腔出血（SCH）是一种罕见但可能威胁视力的事件，长期视力预后较差。目前，在治疗中手术干预还是保守治疗更具优势尚无定论。我们报告了一例年轻先天性青光眼患者单眼针刺术后严重SCH自发消退的病例。
一名43岁先天性青光眼女性患者计划对其单眼进行滤过泡针刺术。术前最佳矫正视力为20/40，眼压为20 mmHg。术后第三天，她出现了大量延迟性SCH，伴有贴附性（亲吻性）脉络膜大泡，视力为手动。10天后进行了巩膜引流，但脉络膜肿胀未显著减轻，于是讨论进一步的保守治疗。2个月后，脉络膜肿胀完全消退，最佳矫正视力为20/50，眼压为11 mmHg。
先天性青光眼针刺术后大量延迟性SCH采用保守治疗可实现功能完全恢复并减轻脉络膜肿胀。
