|Year : 2021 | Volume
| Issue : 3 | Page : 461
Active vitreous hemorrhage on real-time video-angiography
Mumin Hocaoglu1, Isil Sayman Muslubas1, M Giray Ersoz2, Serra Arf1, Murat Karacorlu1
1 Vitreoretinal Diseases and Surgery, Istanbul Retina Institute, Istanbul, Turkey
2 Vitreoretinal Diseases and Surgery, Biruni University School of Medicine, Istanbul, Turkey
|Date of Web Publication||02-Jul-2021|
Vitreoretinal Diseases and Surgery, Istanbul RETINA Enstitüsü, Hakki Yeten Cad. Unimed Center No: 19/7, Fulya – Sisli, Istanbul - 34349
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Hocaoglu M, Muslubas IS, Ersoz M G, Arf S, Karacorlu M. Active vitreous hemorrhage on real-time video-angiography. Indian J Ophthalmol Case Rep 2021;1:461
|How to cite this URL:|
Hocaoglu M, Muslubas IS, Ersoz M G, Arf S, Karacorlu M. Active vitreous hemorrhage on real-time video-angiography. Indian J Ophthalmol Case Rep [serial online] 2021 [cited 2021 Jul 28];1:461. Available from: https://www.ijoreports.in/text.asp?2021/1/3/461/320023
A 63-year-old male patient with a history of systemic hypertension and coronary artery disease presented for an annual ophthalmic examination. On examination, visual acuity was 20/20 OU and intraocular pressure was 14 mm Hg OU. The anterior segment was unremarkable. Fundus examination revealed bilateral grade I–II hypertensive retinopathy. Additionally, arteriovenous nicking close to the optic disc inferiorly with diffuse hemorrhages in the inferorotemporal quadrant consistent with inferior branch retinal vein occlusion were observed in the left eye. Both video and still-frame fluorescein angiography images were obtained using the Spectralis HRA + OCT imaging platform (Heidelberg Engineering, Heidelberg, Germany). Fluorescein angiography of the left eye showed delayed filling and tortuosity of the occluded retinal vein, and blocked fluorescence due to retinal hemorrhages [Figure 1]a. About four minutes following the injection of fluorescein dye, an extravasation of blood from the retinal area adjacent to temporal vascular arcade into the vitreous cavity was observed [Figure 1]b and [Figure 1]c. Shortly thereafter, the bleeding stopped spontaneously [Figure 1]d. The cross-sectional retinal optical coherence tomography image showed thickened inner retina temporal to the fovea with superficial hemorrhages which produce an underlying shadow effect [Figure 1]e.
|Figure 1: (a) Fluorescein angiography demonstrates arteriovenous nicking inferior to the optic disc, tortuosity of the occluded retinal vein and blocked fluorescence due to superficial hemorrhages. (b) About four minutes after the injection of fluorescein an active bleeding from the retinal area adjacent to temporal vascular arcade is observed (c) The blood is leaking down to the vitreous space. (d) Soon afterwards the bleeding spontaneously resolves. (e) The cross-sectional retinal optical coherence tomography image showed thickened inner retina temporal to the fovea with superficial hemorrhages which produce an underlying shadow effect|
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Fluorescein angiography is a valuable diagnostic modality in cases of branch retinal vein occlusion. However, documentation of active hemorrhage during fluorescein angiography is a remarkably uncommon entity and only a few cases have been reported in the literature.,,,, More importantly we provide a dynamic fluorescein angiography video recording [Video, Supplemental Digital Content 1]. A possible explanation that has been proposed for this event could be a valsalva retinopathy like phenomenon when a sudden increase in intrathoracic or intraabdominal pressure leads to spontaneous rupture of superficial retinal vessels.,,,
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
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Conflicts of interest
There are no conflicts of interest.
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