The role of ultrasonography in management of vitreous hemorrhage: case report and literature review

Kamilė Grigaitė1, Martynas Špečkauskas2

1Lithuanian University of Health Sciences, Academy of Medicine, Kaunas, Lithuania

2Department of Ophthalmology, Lithuanian University of Health Sciences, Kaunas, Lithuania



Background: Vitreous hemorrhage (VH) is the presence of extravasated blood within the space defined by the internal limiting membrane of the retina posteriorly and laterally, the nonpigmented epithelium of the ciliary body laterally, and the lens zonular fibers and posterior lens capsule anteriorly. The treatment of unknown-cause VH can be conservative, but in some cases, such as retinal tear or detachment, it is suggested to perform pars plana vitrectomy (PPV) early to avoid irreversible vision impairment. However, it is important to evaluate the possible risks of surgical intervention and prognosis of vision acuity associated with the leading cause of VH.

The aim: to present a clinical case of vitreous hemorrhage with retinal tears diagnosed in the Hospital of Lithuanian University of Health Sciences Kauno Klinikos and review the latest scientific literature of vitreous hemorrhage causes, findings in ultrasonography and treatment.

Material and methods: recently published studies were reviewed to evaluate the latest findings in vitreous hemorrhage causes, findings in ultrasonography and treatment. Clinical case of vitreous hemorrhage was presented. Databases from the subscription list of Lithuanian University of Health Sciences were selected: PubMed, SpringerLink, ScienceDirect.

Results: A 61-year-old male patient complaining of a sudden vision worsening and cobwebs in the vision field of the left eye underwent ophthalmic examination. Ultrasonography (US) of the left eye (LE) has been done because of the lack of information during the fundoscopic examination. It showed acoustic hyperdensity in the vitreous, corresponding to vitreous hemorrhage. Urgent PPV was performed to avoid retinal detachment.

Conclusion: VH is a common reason of painless unilateral visual worsening which can be irreversible. US has proven to be an effective diagnostic tool, which helped to identify VH caused by retinal tears and determine the urgency of surgical intervention. PPV has shown to be the main treatment method for dense VH caused by retinal tears with minimal complications risk and promising outcomes.

Keywords: vitreous hemorrhage, B-scan, ultrasonography, vitrectomy.