title: Visual acuity outcomes among patients with appositional suprachoroidal hemorrhage.
abstract: OBJECTIVE
  The purpose of the study is to investigate visual acuity outcomes among patients with appositional suprachoroidal hemorrhage and to identify clinical features associated with visual prognosis.
  
  
  METHODS
  The study design was a retrospective chart review.
  
  
  METHODS
  All patients whose ocular echographic examination results showed appositional suprachoroidal hemorrhage at the Bascom Palmer Eye Institute between January 1, 1987, and December 31, 1996 were included. Fifty-one patients were identified.
  
  
  METHODS
  Demographic and clinical data were abstracted from patients' medical records.
  
  
  METHODS
  Visual acuity at 3, 6, and 12 months posthemorrhage and clinical features associated with visual prognosis were defined.
  
  
  RESULTS
  At final follow-up fifteen (29.4%) patients achieved either their prehemorrhage visual acuity (n = 7) or a visual acuity of 20/200 or better (n = 8), but 14 (27.5%) patients had no light perception. Predictors of a poor visual outcome include vitreous incarceration in the wound/bleb (P = 0.014), concurrent or delayed retinal detachment (P = 0.003), and afferent pupillary defect on presentation (P = 0.002). Poorer visual acuity on presentation (r = 0.37, P = 0.008) and longer duration of central retinal apposition (r = 0.51, P < 0.001) also were significantly associated with poor final visual acuity. Patients in whom the suprachoroidal hemorrhage maintained an appositional configuration for more than 14 days were more likely to have worse final visual acuities than were patients with appositional choroidals for fewer than 14 days (P = 0.006). The association between duration of apposition and final visual acuity was significant, both among patients whose suprachoroidal hemorrhages were observed (n = 26, r = 0.60, P = 0.001) and among patients who underwent secondary surgical intervention (n = 23, r = 0.66, P = 0.001). Patients with postoperative suprachoroidal hemorrhages achieved better final visual acuities than did patients in whom suprachoroidal hemorrhages developed intraoperatively or after trauma (P = 0.038).
  
  
  CONCLUSIONS
  Appositional suprachoroidal hemorrhage is a serious ocular complication with a guarded visual prognosis. A variety of clinical features, including vitreous incarceration in the wound/bleb, concurrent or delayed retinal detachment, afferent pupillary defect, presenting visual acuity, and duration of central retinal apposition, may help predict visual outcome.
authors.affiliation: Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, Florida 33139, USA.
authors.forename: I U
authors.initials: IU
authors.lastname: Scott
authors.forename: H W
authors.initials: HW
authors.lastname: Flynn
authors.forename: J
authors.initials: J
authors.lastname: Schiffman
authors.forename: W E
authors.initials: WE
authors.lastname: Smiddy
authors.forename: T G
authors.initials: TG
authors.lastname: Murray
authors.forename: F
authors.initials: F
authors.lastname: Ehlies
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002832:Choroid Hemorrhage / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D003320:Corneal Ulcer / Q000150:complications; D005131:Eye Injuries / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012599:Sclerostomy; D014792:Visual Acuity / Q000502:physiology*; D014821:Vitrectomy; D014949:Wounds, Nonpenetrating / Q000150:complications