title: Suprachoroidal hemorrhage: outcome of surgical management according to hemorrhage severity.
abstract: OBJECTIVE
  To report the visual and anatomic outcome after surgical drainage of suprachoroidal hemorrhage according to hemorrhage severity.
  
  
  METHODS
  A retrospective chart review.
  
  
  METHODS
  Forty-eight consecutive eyes undergoing surgical drainage of a suprachoroidal hemorrhage at The Medical College of Wisconsin were examined.
  
  
  METHODS
  Demographic and clinical data were abstracted from patients' medical records. Eyes were classified into four categories of increasing hemorrhage complexity: (1) nonappositional choroidal hemorrhage without vitreous or retinal incarceration in the wound (12 eyes); (2) centrally appositional choroidal hemorrhage without vitreous or retinal incarceration in the wound (17 eyes); (3) choroidal hemorrhage with associated vitreous incarceration in the wound (11 eyes); and (4) choroidal hemorrhage with associated retinal incarceration in the wound (8 eyes).
  
  
  METHODS
  Visual acuity, rate of persistent hypotony, and incidence of irreparable retinal detachment after surgical drainage for four classes of suprachoroidal hemorrhage were defined.
  
  
  RESULTS
  Overall, 11 (23%) of 48 eyes had no light perception (NLP) vision develop, 9 (19%) of 48 eyes had persistent postsurgical hypotony (intraocular pressure < 6), and 21 (64%) of 33 eyes with retinal detachment enjoyed successful retinal reattachment surgery. A definite trend toward an increased rate of NLP vision (P < 0.02), persistent hypotony (P < 0.05), and irreparable retinal detachment (P = 0.11) was observed with increasing suprachoroidal hemorrhage complexity. Eyes with retinal incarceration, compared to eyes without retinal incarceration, had an increased rate of NLP vision (63% vs. 15%; P < 0.01), persistent postsurgical hypotony (50% vs. 13%; P < 0.05), and irreparable retinal detachment (50% vs. 20%; P = 0.07).
  
  
  CONCLUSIONS
  Eyes requiring surgical drainage of a suprachoroidal hemorrhage have a guarded prognosis, with a poorer outcome associated with increasing hemorrhage complexity. A classification system incorporating choroidal apposition, and vitreous and retinal incarceration in the wound, provides a format for reporting and assessing the efficacy of management strategies in this condition.
authors.affiliation: The Eye Institute, Medical College of Wisconsin, Milwaukee 53226, USA.
authors.forename: W J
authors.initials: WJ
authors.lastname: Wirostko
authors.forename: D P
authors.initials: DP
authors.lastname: Han
authors.forename: W F
authors.initials: WF
authors.lastname: Mieler
authors.forename: J S
authors.initials: JS
authors.lastname: Pulido
authors.forename: T B
authors.initials: TB
authors.lastname: Connor
authors.forename: E
authors.initials: E
authors.lastname: Kuhn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002832:Choroid Hemorrhage / Q000145:classification* / Q000150:complications / Q000601:surgery*; D004322:Drainage / Q000379:methods*; D005128:Eye Diseases / Q000209:etiology; D005260:Female; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D012163:Retinal Detachment / Q000209:etiology / Q000601:surgery; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy; D014822:Vitreous Body / Q000473:pathology / Q000601:surgery