A rare case of acute angle closure due to spontaneous suprachoroidal haemorrhage secondary to loss of anti-coagulation control: a case report

BMC Ophthalmol. 2018 Sep 14;18(Suppl 1):224. doi: 10.1186/s12886-018-0857-4.

Abstract

Background: Suprachoroidal haemorrhage is a rare complication of either medical anticoagulation treatment or intraocular surgical procedures. Suprachoroidal haemorrhages often have devastating visual outcome despite conservative and/or surgical intervention.

Case presentation: A patient with known Open Angle Glaucoma and Atrial Fibrillation on warfarin presents symptoms and signs suggestive acute angle closure. Examination reveals the underlying cause is a large, macula involving, spontaneous suprachoroidal haemorrhage secondary to loss of anti-coagulation control. Following aggressive medical treatment and surgical intervention, including drainage combined cataract extraction with intraocular lens implant, pars-plana vitrectomy, and external drainage of suprachoroidal haematoma, we managed to preserve the patient's eye and some of its function.

Conclusion: Spontaneous suprachoroidal haemorrhages are rare complications of loss of anticoagulation control. Our case shows that aggressive treatment in selected cases can offer a relatively good outcome.

Keywords: Acute angle closure; Anticoagulation; Suprachoroidal haemorrhage.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Aged
  • Anticoagulants / adverse effects*
  • Anticoagulants / therapeutic use
  • Atrial Fibrillation / drug therapy
  • Blood Coagulation Disorders / chemically induced*
  • Blood Coagulation Disorders / diagnosis
  • Choroid Hemorrhage / etiology*
  • Glaucoma, Angle-Closure / etiology*
  • Humans
  • Intraocular Pressure
  • Male
  • Visual Acuity
  • Warfarin / adverse effects*
  • Warfarin / therapeutic use

Substances

  • Anticoagulants
  • Warfarin