Journal of Pediatric Perspectives

Journal of Pediatric Perspectives

Spontaneous Bilateral Suprachoroidal Hemorrhage in a Child with Idiopathic Thrombocytopenic Purpura: A Case Report

Document Type : case report

Authors
Mehrdad Motamed Shariati 1
Mohsen Mohammadzade 1
Seyedeh Maryam Hosseini 1
Seyed Hossein Ghavami Shahri 2
Mitra Karimi Amir Abadi 3
Javad Sadeghi 3
1 Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
2 Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
3 Eye research center, Mashhad University of Medical Sciences, Mashhad, Iran
10.22038/ijp.2023.72944.5293
Abstract
Purpose: This study aimed to report the case of a 3-year-old child with Idiopathic Thrombocytopenic Purpura (ITP) presented with massive bilateral spontaneous suprachoroidal hemorrhage.
Case report: A three-year-old boy with a history of ITP was referred with acute painful vision loss from 2 days ago. Visual acuity was No Light Perception (NLP) for the Right Eye (RE) and Light Perception (LP) for the Left Eye (LE). Anterior segment examination showed bilateral red eye, mild corneal edema, as well as relatively shallow and symmetric anterior chamber. Bilateral massive suprachoroidal hemorrhage with retinal apposition was apparent in B-scan ultrasonography. The patient underwent bilateral SCH drainage through four sclerotomy windows, one in each quadrant of each eye. In the last follow-up examination, one week after the surgery, the visual acuity was light perception and hand motion in RE and LE, respectively. Serial B-scan sonography indicated the reduction of hemorrhage in the suprachoroidal space.
Conclusion: Spontaneous Supra-choroidal Hemorrhage (SSCH) is an extremely rare condition that can occur in the case of ITP. Despite the anatomical recovery of the patient following suprachoroidal drainage surgery, the visual outcome remained poor.
Keywords
Spontaneous suprachoroidal hemorrhage,,
,،Idiopathic thrombocytopenic purpura,,
,،Scleral window
  1. Hsiao S-F, Shih M-H, Huang F-C. Spontaneous suprachoroidal hemorrhage: case report and review of the literature. Taiwan Journal of Ophthalmology. 2016; 6(1):36-41.
  2. Kontou E. Management and diagnosis of subretinal and suprachoroidal haemorrhage. Acta Ophthalmologica. 2022; 100.
  3. Qureshi A, Jalil A, Sousa DC, Patton N, Dhawahir-Scala F, Charles SJ, Turner G, Ivanova T. Outcomes of suprachoroidal haemorrhage drainage with and without vitrectomy: a 10-year study. Eye. 2021; 35(7):1879-85.
  4. Cruz-Pimentel M, Mehraban Far P, Brent MH, Yan P. Massive Spontaneous Suprachoroidal Hemorrhage in a Patient with Type 1 Chronic Myeloid Leukemia and Lymphoplasmacytic Lymphoma: Case Report and Review of the Literature. Journal of VitreoRetinal Diseases. 2022:24741264221074799.
  5. Chai F, Zeng L, Li C, Zhao X. Spontaneous suprachoroidal hemorrhage in a high myopia patient with rhegmatogenous retinal detachment: a case report and literature review. Bioscience Reports. 2019; 39(6).
  6. Onisâi M, Vlădăreanu A-M, Spînu A, Găman M, Bumbea H. Idiopathic thrombocytopenic purpura (ITP)–new era for an old disease. Romanian Journal of Internal Medicine. 2019; 57(4):273-83.
  7. Shan H, Wu X, Guo H. Spontaneous suprachoroidal and orbital hemorrhage in an older woman associated with prophylactic antiplatelet therapy: A case report and literature review. Heliyon. 2022; 8(11):e11511.
  8. Frcs JSW. Spontaneous suprachoroidal haemorrhage in a patient receiving low‐molecular‐weight heparin (fraxiparine) therapy. Australian and New Zealand journal of ophthalmology. 1999; 27(6):433-4.
  9. Hammam T, Madhavan C. Spontaneous suprachoroidal haemorrhage following a valsalva manoeuvre. Eye. 2003; 17(2):261-2.
  10. Ling R, Cole M, James C, Kamalarajah S, Foot B, Shaw S. Suprachoroidal haemorrhage complicating cataract surgery in the UK: epidemiology, clinical features, management, and outcomes. British Journal of Ophthalmology. 2004; 88(4):478-80.
  11. Majoor CJ, Sneeboer MMS, Kievit Ad, Meijers JCM, Poll Tvd, Lutter R, Bel EH, Kamphuisen PW. The influence of corticosteroids on hemostasis in healthy subjects. Journal of Thrombosis and Haemostasis. 2016; 14(4):716-23.
  12. Bernfield M, Götte M, Park PW, Reizes O, Fitzgerald ML, Lincecum J, Zako M. Functions of cell surface heparan sulfate proteoglycans. Annual review of biochemistry. 1999; 68(1):729-77.
Journal of Pediatric Perspectives
Volume 11, Issue 6
June 2023
Pages 18008-18012