Ng Jonathan K Y, Peilober-Richardson Antonia, Ku Jae Yee, Jasani Kirti, Haider David
Ophthalmology, Manchester Royal Eye Hospital, Manchester University NHS Foundation Trust, Manchester, GBR.
Ophthalmology, Royal Bolton Hospital, Bolton NHS Foundation Trust, Bolton, GBR.
Cureus. 2023 Aug 1;15(8):e42817. doi: 10.7759/cureus.42817. eCollection 2023 Aug.
Suprachoroidal hemorrhage (SCH) is an uncommon sight-threatening pathology, most often encountered intraoperatively. However, spontaneous presentation of SCH is even rarer. We report the case of a 69-year-old diabetic patient with spontaneous SCH (SSCH) in her left eye masquerading as a vitreous hemorrhage. She developed treatment-resistant secondary angle-closure glaucoma. She was referred to the vitreoretinal team for intraocular exploration to identify the source of the hemorrhage. Pars plana vitrectomy identified extensive SCH intraoperatively. As far as the authors are aware, this is the first case in which the patient had such severe SSCH that the characteristic kissing choroidal sign was not visualized on repeated examinations and multimodal imaging. All initial evidence pointed towards a diagnosis of vitreous hemorrhage. This case demonstrates that if a patient has angle-closure glaucoma and persistently raised intra-ocular pressure that is treatment-resistant, then SCH is an important differential diagnosis to consider. Clinicians need to be aware of the risk factors of SCH, and early recognition with a timely intervention of SCH is important to optimize visual outcomes.
脉络膜上腔出血（SCH）是一种罕见的、威胁视力的病变，最常在手术中出现。然而，自发性脉络膜上腔出血（SSCH）的情况更为罕见。我们报告了一例69岁的糖尿病患者，其左眼出现自发性脉络膜上腔出血，最初被误诊为玻璃体积血。她还并发了药物治疗无效的继发性闭角型青光眼。她被转诊至玻璃体视网膜专科团队进行眼内探查，以确定出血来源。经扁平部玻璃体切除术，术中发现广泛的脉络膜上腔出血。据作者所知，这是首例患者出现如此严重的自发性脉络膜上腔出血，以至于在多次检查和多模式成像中均未观察到典型的脉络膜接吻征。所有初步证据均指向玻璃体积血的诊断。该病例表明，如果患者患有闭角型青光眼且眼压持续升高且药物治疗无效，那么脉络膜上腔出血是一个重要的鉴别诊断。临床医生需要了解脉络膜上腔出血的危险因素，早期识别并及时干预对于优化视觉预后非常重要。
