Klin Monbl Augenheilkd 2013; 230(4): 440-442
DOI: 10.1055/s-0032-1328397
Der interessante Fall
Georg Thieme Verlag KG Stuttgart · New York

Hyaloidotomy for Subhyaloidal Hemorrhage: OCT Findings of two Different Treatment Modalities

Hyaloidotomie bei subhyaloidaler Hämorrhagie: Darstellung zweier Behandlungsoptionen mittels OCT
M. Menghini
University Hospital Zurich, Department of Ophthalmology, Zurich, Switzerland
,
J. Fleischhauer
University Hospital Zurich, Department of Ophthalmology, Zurich, Switzerland
,
R. Eberhard
University Hospital Zurich, Department of Ophthalmology, Zurich, Switzerland
,
S. Zweifel
University Hospital Zurich, Department of Ophthalmology, Zurich, Switzerland
› Author Affiliations
Further Information

Publication History

Publication Date:
29 April 2013 (online)

Introduction

Premacular subhyaloidal hemorrhage typically causes acute profound visual deterioration. Common causes for a subhyaloidal hemorrhage are retinal arterial macroaneurysms, arterial hypertension, diabetic retinopathy, hematological disorders and ocular trauma [1], [2], [3], [4]. In healthy adults it can be caused by a Valsalva maneuver leading to spontaneous rupture of superficial retinal capillaries [5]. Using spectral-domain optical coherence tomography (SD-OCT) the anatomical location of the hemorrhage can be exactly determined.

Controversy still exists about the best time for treatment and the specific treatment modality [6], [7]. Nd:YAG-laser-hyaloidotomy has been suggested in recent years to facilitate blood drainage and restoring vision faster [8], [9]. Thanks to the introduction of SD-OCT we are now able to precisely image the site of laser impact and to compare different lasers used for hyaloidotomy. We describe a case where both diode- and Nd:YAG-laser treatment have been consecutively applied with only the latter being successful at drainage and showing a visible effect on SD-OCT.

 
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