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StatPearls-/-ä 2024[Jan]; ä (ä): ä PMID33620856show ga
Intraocular hemorrhage means bleeding inside the eye. Bleeding can occur from any of the structures of the eye where there is a presence of vasculature. It can bleed inside the anterior chamber, vitreous cavity, retina, choroid, suprachoroidal space, or optic disc. It could occur either because of trauma or in association with systemic illness, or very rarely, it could occur spontaneously. Intraocular hemorrhage can be subdivided depending on the location of the bleed: Hyphema Bleeding from the iris, ciliary body, trabecular meshwork, and associated vasculature into the anterior chamber (bordered by cornea anteriorly, iridocorneal angles laterally, and lens posteriorly) is known as hyphema. Microhyphema- a very minimal amount of blood in the anterior chamber, which is detectable only on microscopic examination. Vitreous Hemorrhage Bleeding in and around the anterior chamber of the eye is known as vitreous hemorrhage. It can be further subclassified as: Intragel hemorrhage: Extravasation of blood into space lined anteriorly by an anterior hyaloid membrane, laterally by non-pigmented ciliary epithelium, and posteriorly by the posterior hyaloid membrane is known as intragel hemorrhage. Properties of intragel hemorrhage: Settle inferiorly, Clots easily, As the RBC degenerates, the color of the vitreous hemorrhage changes from bright red to yellow. Preretinal hemorrhage can be subdivided into 2 categories: Subhyaloid hemorrhage is located between the internal limiting membrane and posterior subhyaloid membrane. Boat-shaped configuration: If the posterior hyaloid is intact, subhyaloid hemorrhage is immobile. If the posterior hyaloid is detached, subhyaloid hemorrhage shifts with the eye movement. It is most commonly seen in patients with proliferative diabetic retinopathy. Sub-ILM hemorrhage is bleeding between the internal limiting membrane and the nerve fiber layer of the retina is known as sub-ILM hemorrhage. It is immobile. It also has a boat-shaped configuration, with the upper border being horizontal. Sub ILM hemorrhage is most commonly seen with Valsalva retinopathy, Terson syndrome, and Retinal microaneurysm. If there is hemorrhage inside the Berger space, Cloquet canal, or canal of petit, it is also known as vitreous hemorrhage. Suprachoroidal hemorrhage occurs due to the rupture of long or short ciliary arteries into the suprachoroidal space between the choroid and sclera. It usually occurs intraoperatively and postoperatively, after trauma, and very rarely spontaneously. It can be subclassified as: Intraoperative - also known as expulsive suprachoroidal hemorrhage. Postoperative - also known as delayed suprachoroidal hemorrhage. . Retinal hemorrhages are important markers signifying local or systemic vascular abnormality, which needs to be thoroughly investigated. Retina hemorrhages can occur at the following locations: Flame-shaped hemorrhages are located in the nerve fiber layer. Dot and blot hemorrhages are located in the Outer plexiform layer - Inner nuclear layer (OPL-INL)complex. Subhyaloid hemorrhages are located between the internal limiting membrane and the posterior hyaloid membrane. It is boat-shaped in the configuration. Sub-RPE hemorrhage is located between the retinal pigment epithelium and Bruch membrane. Subretinal hemorrhage- It is located between the RPE(retinal pigment epithelium) and the photoreceptor layer. Disc hemorrhage (also known as Drance hemorrhage): Linear hemorrhages which are perpendicular to the optic disc. The most common location is at the superotemporal or inferotemporal margin. Submacular hemorrhage needs a special mention as it is directly responsible for the quality of vision.
StatPearls-/-ä 2024 ; ä (ä): ä
