Rhegmatogenous retinal detachment associated with spontaneous suprachoroidal hemorrhage in high myopia patients: two case reports and systematic review.

PURPOSE: This study aimed to compare the clinical presentation, treatment, and prognosis of two patients with high myopia who suffered rhegmatogenous retinal detachment (RRD) associated with spontaneous suprachoroidal hemorrhage (SSCH) with similar cases discussed in the literature.

METHODS

The clinical data of two high myopia patients with RRD associated with SSCH were extracted. A systematic review of the literature was conducted using various databases. The clinical characteristics, treatments, and prognoses of the two cases treated at our hospital were compared with the case reports described in the literature.

RESULTS

Both patients presented at our hospital with elongated axial eye lengths and hypotony. The patients underwent 23G recombinant tissue plasminogen activator (r-tPA)-assisted vitrectomy combined with silicone oil (SO) injection. The literature review identified seven similar cases. The intraocular pressure (IOP) in the literature cases ranged from 2 to 10 mmHg. Seven patients discussed in the literature had elongated axial lengths, of whom six had axial eye lengths measuring over 30 mm. All cases were managed with vitrectomy, and five out of the seven cases subsequently developed proliferative vitreoretinopathy (PVR).

CONCLUSION

RRD associated with SCH is an exceptionally rare condition, often leading to poor final visual outcomes. Long axial length appears to be the primary risk factor. Most patients present with hypotony, reflecting the underlying pathogenesis. r-tPA-assisted vitrectomy performed within 7 days following diagnosis may help reduce SCH and improve the likelihood of successful retinal reattachment.