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Indian Journal of Ophthalmology Jan 2023Vitreous hemorrhage is associated with a myriad of conditions such as proliferative diabetic retinopathy, proliferative retinopathy following vascular occlusion and... (Review)
Review
Vitreous hemorrhage is associated with a myriad of conditions such as proliferative diabetic retinopathy, proliferative retinopathy following vascular occlusion and vasculitis, trauma, retinal breaks, and posterior vitreous detachment without retinal break. Multiple pathological mechanisms are associated with development of vitreous hemorrhage such as disruption of abnormal vessels, normal vessels, and extension of blood from an adjacent source. The diagnosis of vitreous hemorrhage requires a thorough history taking and clinical examination including investigations such as ultra-sonography, which help decide the appropriate time for intervention. The prognosis of vitreous hemorrhage depends on the underlying cause. Treatment options include observation, laser photo-coagulation, cryotherapy, intravitreal injections of anti-vascular endothelial growth factor, and surgery. Pars plana vitrectomy remains the cornerstone of management. Complications of vitreous hemorrhage include glaucoma (ghost cell glaucoma, hemosiderotic glaucoma), proliferative vitreoretinopathy, and hemosiderosis bulbi.
Topics: Humans; Vitreous Hemorrhage; Vitrectomy; Vitreous Detachment; Vitreoretinopathy, Proliferative; Diabetic Retinopathy; Glaucoma; Retinal Perforations
PubMed: 36588205
DOI: 10.4103/ijo.IJO_928_22 -
Survey of Ophthalmology 1997The incidence of spontaneous vitreous hemorrhage is approximately 7 cases per 100,000 population. Proliferative diabetic retinopathy (32%), retinal tear (30%),... (Review)
Review
The incidence of spontaneous vitreous hemorrhage is approximately 7 cases per 100,000 population. Proliferative diabetic retinopathy (32%), retinal tear (30%), proliferative retinopathy after retinal vein occlusion (11%) and posterior vitreous detachment without retinal tear (8%) are the most common causes of spontaneous vitreous hemorrhage. Vitreous hemorrhage can be caused by the pathologic mechanisms of disruption of normal retinal vessels, bleeding from diseased retinal vessels or abnormal new vessels, and extension of hemorrhage through the retina from other sources. Hemorrhage into the vitreous gel results in rapid clot formation and is followed by slow clearance of approximately 1% per day. The cellular response to vitreous hemorrhage is unusual with regard to hemorrhage in any tissue outside the vitreous cavity and has been compared to a "low-turnover" granuloma. Unique clinicopathologic features of long-standing vitreous hemorrhage include cholesterolosis bulbi (synchysis scintillans), hemoglobin spherulosis, and vitreous cylinders. Complications of nonclearing vitreous hemorrhage are hemosiderosis bulbi and glaucoma. Ghost cell glaucoma, hemolytic glaucoma, and hemosiderotic glaucoma may result from vitreous hemorrhage. The established treatment option for nonclearing vitreous hemorrhage is pars plana vitrectomy. Experimental nonsurgical treatment options involve improvement of physiologic clearance mechanisms in order to accelerate fibrinolysis, liquefaction, hemolysis and phagocytosis.
Topics: Animals; Cryotherapy; Humans; Prognosis; Vitrectomy; Vitreous Hemorrhage
PubMed: 9265701
DOI: 10.1016/s0039-6257(97)84041-6 -
Indian Journal of Ophthalmology Jun 2019Vitreous hemorrhage is one of the most common causes of sudden, painless loss of vision in adults. This is probably one of the reasons why it has been extensively... (Review)
Review
Vitreous hemorrhage is one of the most common causes of sudden, painless loss of vision in adults. This is probably one of the reasons why it has been extensively studied and reported in literature. However, the same cannot be said when it comes to vitreous hemorrhage in the pediatric age group. The causes of vitreous hemorrhage in children tend to differ from those of adults. Not much data exist regarding their presentation and management. In addition to trauma, certain spontaneous causes such as pediatric tumors and congenital conditions assume importance while considering the differential diagnosis of vitreous hemorrhage in the pediatric age group. However, it is natural that the treating ophthalmologist is faced with challenges when a child presents with vitreous hemorrhage. In this narrative review, we have attempted to analyze the retrospective observational studies regarding pediatric vitreous hemorrhage reported in English literature till date. The article sheds some light on the prevailing epidemiology, management strategies employed and the visual outcome among different regions of the world.
Topics: Child; Disease Management; Global Health; Humans; Morbidity; Visual Acuity; Vitreous Body; Vitreous Hemorrhage
PubMed: 31124481
DOI: 10.4103/ijo.IJO_688_18 -
Journal Francais D'ophtalmologie Feb 2016Spontaneous vitreous hemorrhage is a serious disease whose incidence is 7 per 100,000 people per year. Posterior vitreous detachment with or without retinal tear,... (Review)
Review
Spontaneous vitreous hemorrhage is a serious disease whose incidence is 7 per 100,000 people per year. Posterior vitreous detachment with or without retinal tear, diabetic retinopathy, vascular proliferation after retinal vein occlusion, age-related macular degeneration and Terson's syndrome are the most common causes. Repeated ultrasonography may ignore a retinal tear or detachment and delay vitrectomy that is the only treatment for serious forms. The occurrence of retinal tear or detachment is a surgical emergency as well as rubeosis or diabetic tractional retinal detachment involving the macula. Intravitreal injection of antiangiogenic agents are helpful in clearing the vitreous cavity, facilitating laser photocoagulation and reducing the risks of bleeding during preretinal neovascular membranes dissection.
Topics: Anticoagulants; Diabetic Retinopathy; Humans; Hypertension; Macular Degeneration; Retinal Detachment; Retinal Perforations; Vitrectomy; Vitreous Detachment; Vitreous Hemorrhage
PubMed: 26826742
DOI: 10.1016/j.jfo.2015.11.001 -
Ophthalmology Apr 2023
Topics: Humans; Vitreous Hemorrhage; Papilledema; Vitreous Body; Massage
PubMed: 36781350
DOI: 10.1016/j.ophtha.2022.12.015 -
Retinal Cases & Brief Reports Sep 2021
Topics: Humans; Polyneuropathies; Vitrectomy; Vitreous Body; Vitreous Hemorrhage
PubMed: 34171903
DOI: 10.1097/ICB.0000000000001152 -
Journal Francais D'ophtalmologie Mar 2021
Topics: Aneurysm; Humans; Optic Disk; Retinal Artery; Retinal Hemorrhage; Vitreous Hemorrhage
PubMed: 33190959
DOI: 10.1016/j.jfo.2020.04.047 -
Vitreous Hemorrhage in Pediatric Patients With X-Linked Retinoschisis: Characteristics and Outcomes.Ophthalmic Surgery, Lasers & Imaging... Sep 2023To report the management and outcomes of vitreous hemorrhage in pediatric patients with X-linked retinoschisis (XLRS).
OBJECTIVE
To report the management and outcomes of vitreous hemorrhage in pediatric patients with X-linked retinoschisis (XLRS).
MATERIALS AND METHODS
Retrospective case series of pediatric patients with XLRS with vitreous hemorrhage between January 2000 and January 2022 at the Bascom Palmer Eye Institute.
RESULTS
Nine patients (12 eyes) met inclusion criteria. The average age at presentation was 5.75 years and mean follow-up time was 6 years. All eyes (58.3%) that underwent fluorescein angiography exhibited peripheral capillary dropout. Six of 12 eyes (50%) were observed without intervention. Four of 12 eyes (33.3%) underwent intravitreal injection of bevacizumab and 2 (16.6%) underwent vitreoretinal surgery. Seven of 12 eyes (58.3%) had documented recurrence of vitreous hemorrhage during follow-up. All retinas were attached and had clear media at final follow-up.
CONCLUSION
Fluorescein angiography is a helpful tool to evaluate the vascular phenotype in XLRS. Favorable anatomic outcomes were noted in this cohort, but recurrence of vitreous hemorrhage was common. .
Topics: Child; Humans; Bevacizumab; Retina; Retinoschisis; Retrospective Studies; Vitreous Hemorrhage
PubMed: 37642422
DOI: 10.3928/23258160-20230803-01 -
International Ophthalmology Clinics 2014Diabetic vitreous hemorrhage secondary to proliferative diabetic retinopathy is a cause of severe vision loss in diabetic patients. Laser photocoagulation remains the... (Review)
Review
Diabetic vitreous hemorrhage secondary to proliferative diabetic retinopathy is a cause of severe vision loss in diabetic patients. Laser photocoagulation remains the primary treatment when the view allows. Intravitreous anti-VEGF injections do not appear to have a role as primary treatment but may have an invaluable role as adjuvant to surgery. Pars plana vitrectomy with endolaser panretinal photocoagulation remains the procedure of choice for non-clearing vitreous hemorrhage. The vast majority of patients with vision of 5/200 or less due to diabetic vitreous hemorrhage do not clear spontaneously even after 1 year. With improvements in surgical techniques leading to better outcomes, fewer complications, less discomfort and a faster recovery time it is reasonable to operate on such patients sooner than the 3–4 months that had been generally accepted in the past, if there has been no significant spontaneous improvement.
Topics: Diabetic Retinopathy; Humans; Laser Coagulation; Treatment Outcome; Visual Acuity; Vitrectomy; Vitreoretinopathy, Proliferative; Vitreous Hemorrhage
PubMed: 24613890
DOI: 10.1097/IIO.0000000000000027 -
Aerospace Medicine and Human Performance Nov 2020Spontaneous vitreous hemorrhage is uncommon in the general population. Of cases, 1020% are idiopathic or due to occult causes and a majority of the remainder are...
Spontaneous vitreous hemorrhage is uncommon in the general population. Of cases, 1020% are idiopathic or due to occult causes and a majority of the remainder are associated with diabetic disease. The evaluation and disposition of an aviator has not been reported previously. This case will document the work-up and safe return to flight of a patient. A 33-yr-old male MH-60R pilot presented with acute blurred vision in the left eye and eye pain which began at his desk. His review of systems was otherwise negative. His medical history was noncontributory. On initial examination his vital signs and external ocular exam were normal. He was immediately referred to the optometry clinic, where a dilated funduscopic examination (DFE) with scleral depression demonstrated a large floater OS composed of streaks of blood and tobacco dust. His DFE was otherwise normal with no retinal tears or vitreous detachments. On repeated DFEs, his intraoccular pressures remained normal and his hemorrhage resorbed without decreased visual acuity or field deficits. A hematologic work-up was negative. After 4 mo of observation, the patient was returned to flight status without further recurrence. No known associations exist between aeronautical duties and spontaneous vitreous hemorrhages. The stressors aviators are subjected to, such as high vibrations and increased g forces, may make them more likely to suffer intraocular microvascular damage that could lead to retinal detachment, vitreous detachment, and bleeding. Further reports are needed to determine the risks of recurrence in aviators and their differences from typical spontaneous vitreous hemorrhage patients.
Topics: Humans; Male; Pilots; Vision Disorders; Vitreous Hemorrhage
PubMed: 33334413
DOI: 10.3357/AMHP.5666.2020