脉络膜上腔出血。临床特征及二次手术治疗结果

Suprachoroidal hemorrhage. Clinical features and results of secondary surgical management.

作者信息

Reynolds M G, Haimovici R, Flynn H W, DiBernardo C, Byrne S F, Feuer W

机构信息

Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine 33101.

出版信息

Ophthalmology. 1993 Apr;100(4):460-5.

PMID:8479701

Abstract

PURPOSE

The purposes of this study are to identify clinical features in eyes with suprachoroidal hemorrhage which portend a poor visual prognosis and to determine visual outcome in these eyes after secondary surgical management of suprachoroidal hemorrhage.

METHODS

This was a retrospective study of 106 patients with suprachoroidal hemorrhages occurring in association with trauma (35), cataract surgery (30), glaucoma surgery (17), penetrating keratoplasty (6), corneal perforation (5), secondary lens implantation (3), pars plana vitrectomy (3), and other causes (7).

RESULTS

Five (10%) of 49 eyes with a suprachoroidal hemorrhage and an initial retinal detachment had a visual outcome of 20/200 or better compared with 21 (43%) of 49 eyes without a retinal detachment. The presence or absence or a retinal detachment could not be determined in eight patients and all eight of these patients had a poor visual outcome. Sixteen (20%) of 82 eyes with a 360 degrees suprachoroidal hemorrhage had a visual outcome of 20/200 or better compared with 10 (47%) of 21 for those with suprachoroidal hemorrhage limited to one or two quadrants. The extent of the hemorrhage could not be determined in three eyes. Overall, 34% (14/41) of the patients with suprachoroidal hemorrhage who had a secondary surgical procedure achieved a visual outcome of 20/200 or better. Forty-three percent (6/14) who had a suprachoroidal hemorrhage during or after cataract surgery and who were treated with secondary surgical management achieved a visual outcome of 20/200 or greater.

CONCLUSION

Clinical features associated with a poorer visual outcome included initial or indeterminate retinal detachment and 360 degrees suprachoroidal hemorrhage. Limited suprachoroidal hemorrhage without initial retinal detachment usually has a good visual prognosis and does not usually require secondary surgical intervention. However, if the former complication is present, secondary surgical intervention should be considered.

摘要

目的

本研究的目的是确定脉络膜上腔出血患者中预示视力预后不良的临床特征，并确定这些眼睛在脉络膜上腔出血的二次手术治疗后的视力结果。

方法

这是一项对106例脉络膜上腔出血患者的回顾性研究，这些出血与外伤（35例）、白内障手术（30例）、青光眼手术（17例）、穿透性角膜移植术（6例）、角膜穿孔（5例）、二期晶状体植入（3例）、玻璃体切割术（3例）及其他原因（7例）相关。

结果

49例脉络膜上腔出血且初始伴有视网膜脱离的眼中，5例（10%）视力结果达到20/200或更好，而49例无视网膜脱离的眼中有21例（43%）达到此结果。8例患者无法确定是否存在视网膜脱离，且这8例患者的视力结果均较差。82例发生360度脉络膜上腔出血的眼中，16例（20%）视力结果达到20/200或更好，而脉络膜上腔出血局限于一个或两个象限的21例患者中有10例（47%）达到此结果。3只眼无法确定出血范围。总体而言，接受二次手术的脉络膜上腔出血患者中，34%（14/41）视力结果达到20/200或更好。白内障手术期间或术后发生脉络膜上腔出血并接受二次手术治疗的患者中，43%（6/14）视力结果达到20/200或更好。