Laser membranotomy of acute subhyaloidal hemorrhage after indirect ocular trauma

Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
Jens HeichelArne Viestenz

Abstract

Subhyaloidal premacular hemorrhage (SPH) causes a painless acute loss of vision with central scotoma. Typically, it can be caused by vascular retinal diseases or in the context of a Valsalva retinopathy. Ocular trauma is a less common cause of SPH. This case report describes a 54-year-old male who presented with a painless decrease of vision in the left eye after blunt frontal trauma to the forehead during a car accident. A car accident resulted in an abrupt deceleration of the head by hitting the windscreen. There was no direct trauma to the eyes. The initial visual acuity of the affected left eye was 0.1 and the visual acuity of the right eye was 1.0. Funduscopy verified an incomplete detachment of the posterior vitreous body with rupture of a retinal venous vessel of the temporal upper vascular arch and prominent SPH. Furthermore, a cystoid macular edema was detected. For internal drainage a neodymium-doped yttrium aluminium garnet (Nd:YAG) laser membranotomy of the posterior vitreous body was performed 1 day after the trauma. On the first postoperative day visual acuity increased to 0.32 with a complete resolution of the macular edema. During the follow-up, visual acuity was 1.0 after 3 months and 1.25 after 6 months. Accel...Continue Reading

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