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Case Reports
. 2022 Feb 25;15(2):e245307.
doi: 10.1136/bcr-2021-245307.

Intraoperative haemorrhagic choroidal detachment during MicroIncision Vitrectomy Surgery (MIVS): a unique mechanism

Ashish Markan  1 , Nikitha Ayyadurai  1 , Simar Rajan Singh  1 , Deeksha Katoch  2
Affiliations
Case Reports

Intraoperative haemorrhagic choroidal detachment during MicroIncision Vitrectomy Surgery (MIVS): a unique mechanism

Ashish Markan et al. BMJ Case Rep. .

Abstract

Haemorrhagic choroidal detachment (HCD) is a dreaded intraoperative complication of ophthalmic surgery, despite being rare. Multiple systemic and ocular risk factors of HCD have been reported. Acute hypotony during surgery is considered one of the most important precipitating factors. We herein describe a series of events during pars plana vitrectomy surgery for management of rhegmatogeneous retinal detachment which lead to localised HCD. We believe that the pathogenesis of localised HCD is related to compressive decompressive forces during the final tie of the encircling element after fluid air exchange.

Keywords: ophthalmology; retina.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
(A) Intraoperative image showing the presence of large inferior choroidal mound with associated subretinal bleed near retinotomy site. (B) Postoperative fundus colour photograph and USG at day 1 suggestive of inferior choroidal mound (left panel, red arrow) and haemorrhagic component within the choroidal detachment (right panel, yellow arrow). (C) Postoperative fundus colour photograph and USG at day 7 suggestive of decrease in height of inferior choroidal detachment (left panel, red arrow) and resolution of haemorrhagic component within the choroidal detachment (right panel, yellow arrow). USG, ultrasonography.
Figure 2
Figure 2
(A) Proposed mechanism depicting acute compressive (B) and decompressive forces (C) during final tying of encircling element in air filled vitreous cavity causing a localised HCD (D). HCD, haemorrhagic choroidal detachment.
See this image and copyright information in PMC

References

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