Post-traumatic retro hyaloid hemorrhage managed by Yag laser

Author: Fatimazahrae Bahari (Morocco)

Co-authors: Younes Hidan, Adil Mchachi, Leila Benhmidoune, Abdelwahde Chakib, Ryad Rachid, Mohammed Elbelhadji

Purpose

Retrohyaloidal hemorrhage can complicate a contusive ocular trauma. Although it usually resolves without sequelae, it may require treatment with a Yag laser. Despite the presence of a traumatic context, it is imperative to look for an etiology whose prognosis without treatment can be more serious, and in particular a proliferative diabetic retinopathy, retinal arterial macroaneurysms or a venous branch occlusion.

Setting/Venue

The patient was admitted to the ophtalmology departement of 20 Aout 1953 hospital university of Casablanca

Methods

We report the case of a patient admitted to the emergency room of the 20 August 1953 University Hospital Center in Casablanca

Results

A 32-year-old woman with no significant medical history was admitted to the emergency room for a sudden visual acuity loss in the right eye. The patient’s history reveals a minor contusive trauma that preceded the visual acuity decrease. The examination showed a visual acuity reduced to counting fingers, and an intraocular pressure of 14 mmHg in the right eye. The slit lamp examination was unremarkble. Fundus examination showed a retro-hyaloidal hemorrhage masking all the macula. and extending in upper temporal, The drug-induced and the toxin hypothesis were ruled out through the patient’s history. The blood test did not reveal any diabetes, coagulation disorders or inflammatory syndrome. A complete cardiovascular examination was performed urgently and found no abnormalities. The patient was treated with local and general corticosteroids. Strict rest with copious fluids was encouraged. with no improvement after 3 weeks, we performed 3 shots of 5 mJ with the Nd:YAG laser on the most swollen area of the blood collection, located in the lower part. Consequently, the hemorrhage was rapidly released into the vitreous cavity and completely resorbed within 2 days.

Conlusions

Treatment of retrohyaloidal hemorrhage by posterior hyaloidotomy with the Nd:YAG laser allows complete resorption of the hemorrhage. However, this procedure is risky and therefore it is important to rule out an underlying pathology and to perform it under safe conditions

Financial Disclosure

no financial interests to disclose