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Clinical characteristics and mortality rates for suprachoroidal hemorrhage: seven-year experience at a tertiary eye center

Abstract

Purpose

To investigate comorbidities and medications associated with acute (ASCH) and delayed (DSCH) suprachoroidal hemorrhage (SCH), and to explore visual outcomes and mortality following SCH.

Methods

Retrospective review of SCH cases diagnosed at a tertiary center between 2013 and 2019. Demographics, history, surgery type, visual acuity, intraocular pressure (IOP), and mortality data were reviewed.

Results

Fifty eyes of 50 patients experienced SCH related to surgery: 15 (30%) ASCH and 35 (70%) DSCH. Glaucoma surgery was the most common preceding surgery, and SCH was more likely to be delayed in glaucoma surgery relative to other surgeries (p = 0.001). The proportions of patients on anticoagulant, antiplatelet, or NSAID medications were 30% (n = 15), 52% (n = 26), and 12% (n = 6), respectively. The mean preoperative IOP was 25.0 ± 10.2 mmHg. The mean final best corrected visual acuity did not significantly differ between DSCH and ASCH (logMAR 1.92 vs. 2.36; p = 0.39). After controlling for pre-drainage visual acuity, final visual acuity was not statistically significantly different between eyes that were drained versus those that were not drained (p = 0.06). Of all 50 patients, the mortality rate was 12% with a mean time to mortality after SCH of 754 ± 564 days for those who died.

Conclusion

DSCH was more common than ASCH, with glaucoma surgery being the most common procedure to result in SCH. Visual outcomes and mortality rate were comparable between ASCH and DSCH. Further research is needed regarding the role of surgical drainage on improving visual outcomes in eyes with SCH.

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Acknowledgements

Dr. Thompson is supported by a grant from the National Eye Institute (1K23EY030897-01). There are no other acknowledgements to disclose.

Funding

Dr. Thompson is supported by a grant from the National Eye Institute (1K23EY030897-01) and the American Glaucoma Society.

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All authors whose names appear on the submission 1) made substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data; or the creation of new software used in the work; 2) drafted the work or revised it critically for important intellectual content; 3) approved the version to be published; and 4) agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Corresponding author

Correspondence to Leon Herndon.

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Ethics approval and consent to participate

This retrospective review was conducted with approval from the Duke Institutional Review Board and in accordance with the tenets of the Declaration of Helsinki.

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Not applicable.

Conflict of interest

Financial disclosures: T.L.: none. A.C.T.: none. C.E.W.: none. M.G.H.: none. E.A.P.: Alcon (P), Phase5Creative, Arctic DX (I), L.H.: Glaukos (F), Aeri (F), Alcon (F), Allergan (F), Sight Sciences (F), New World Medical (F), Ocular Therapeutix (F).

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Lee, T., Thompson, A.C., Wisely, C.E. et al. Clinical characteristics and mortality rates for suprachoroidal hemorrhage: seven-year experience at a tertiary eye center. Graefes Arch Clin Exp Ophthalmol (2021). https://doi.org/10.1007/s00417-021-05290-1

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Keywords

  • Glaucoma
  • Suprachoroidal hemorrhage
  • Mortality
  • Visual outcomes