Suprachoroidal Hemorrhage During Pars Plana Vitrectomy Associated with Valsalva Maneuver

ABSTRACT

PURPOSE: To report a suprachoroidal hemorrhage by Valsalva maneuver during vitrectomy under general anesthesia. CASE SUMMARY: A healthy 26-year-old man had vitrectomy under general anesthesia due to rhegmatogenous retinal detachment in his right eye. During scleral indentation and endolaser photocoagulation, he took a sudden and severe bucking reflex because the effect of general anesthesia was insufficient. After the bucking reflex, suprachoroidal hemorrhage occurred in his right eye. Immediate IOP elevation and hyperfluorocarbon tamponade was performed to remove the suprachoroidal hemorrhage and reattach the retina and choroid. The patient's corrected visual acuity was 20/50 and slender crescent shaped choroidal rupture remained around the temporal area of the macula, unlike traumatic choroidal rupture. Following fluorescein angiography, staining was evident at the choroidal rupture site; no fluorescein leakage was evident. CONCLUSIONS: We report a case of acute suprachoroidal hemorrhage which we investigated by fundus examination and fluorescein angiography.