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Suprachoroidal Haemorrhage: 2 case reports In a study, a 79-year-old woman and a 54-year-old man were described, who developed suprachoroidal haemorrhage (SCH) while receiving anticoagulant therapy with acenocoumarol and an unspecified low molecular weight heparin (one patient) or heparin and unspecified anticoagulant (one patient) [dosages and duration of treatments to reactions onsets not stated; not all routes stated]. Case 1: A 79-year-old woman, who had advanced primary open-angle glaucoma (POAG) with confirmed progression in left eye’s visual field, underwent an uneventful nonpenetrating deep sclerectomy (NPDS). She was receiving anticoagulant therapy with acenocoumarol, which was discontinued preoperatively. The anticoagulant therapy was replaced by an unspecified low-molecular-weight heparin, maintained for 1 week. On postoperative day 1, she complained of pain and vision loss. Intraocular pressure (IOP) was 18mm Hg, and visual acuity (VA) was reduced to hand movements. B-scan ultrasonography showed vitreous haemorrhage and a SCH in all 4 quadrants associated with evident choroidal kissing. She was treated with prednisone and underwent pars plana vitrectomy surgery with drainage of the haemorrhagic detachment, 7 days after NPDS surgery. VA was limited to hand motion while an IOP was 10mm Hg for 3 months following surgery. One year after the surgery, no improvement was noted. Case 2: A 54-year-old man, who had POAG, showed fluctuating IOP despite medical treatment. There was further visual field deterioration in his right eye. VA was limited to hand movements while an IOP was 18mm Hg. Subsequently, he underwent NPDS. His unspecified anticoagulant therapy was stopped prior to surgery. The anticoagulant therapy was replaced by SC heparin. On postoperative day 1, he complained of severe pain in his right eye, decreased vision, high IOP, a flat anterior chamber and vomiting. B-scan ultrasonography showed 2 large haemorrhagic choroidal detachments with no kissing. At the end of second month, he was managed and monitored recovering his pre-surgical VA. Following 6 months, his VA was again limited to hand movements only [outcome not stated]. Author comment: "Chronic anticoagulation (ACT) or antiplatelet therapy (APT) are also associated with a significant increase in the rate of hemorrhagic complications in patients undergoing glaucoma surgery.""Furthermore, there were other additional risk factors for SCH, including the use of anticoagulants (cases 1 and 2). . .". Rebolleda G, et al. Supraciliary Implant Placement and Postoperative Suprachoroidal Hemorrhage After Nonpenetrating Deep Sclerectomy. Journal of Glaucoma 27: 389-392, No. 4, Apr 2018. Available from: URL: http:// 803433939 doi.org/10.1097/IJG.0000000000000896 - Spain

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Reactions 16 Nov 2019 No. 1779