What Is a Vitreous Hemorrhage?

Vitreous hemorrhage, vitreous hemorrhage, is a common disease that causes vision loss caused by vascular, inflammatory, tumor, and retinal hiatus. On the one hand, this disease not only makes the refractive medium turbid and prevents the light from reaching the retina, but also has a serious damage to the eye tissues; on the other hand, the body's response to bleeding can gradually clear the blood. In different cases, the consequences are very different, and appropriate clinical treatment should be given in a timely manner according to the primary disease, the amount of blood in the glass volume, the absorption of bleeding, and the performance of the eye reaction.

Basic Information

English name: vitreous hemorrhage
Visiting department: Ophthalmology
Common locations: Vitreous

Common causes: Ocular vascular diseases and injuries, posterior vitreous detachment, retinal hiatus, systemic diseases, etc.
Common symptoms: "Flying mosquitoes", the front shadows flutter, and the eyesight is significantly reduced, etc.
Contagious: no

Causes of vitreous hemorrhage

The disease is mostly caused by ocular vascular diseases and injuries, and can also be caused by posterior vitreous detachment, retinal hiatus and systemic diseases. Ocular trauma and fundus vascular disease are the most common causes of vitreous hemorrhage in the clinic.

Traumatic

In ocular trauma, perforated eyeball injury or blunt contusion of the eyeball can cause traumatic vitreous hemorrhage. In corneal and scleral perforations, scleral perforations, and residual foreign body injuries in the posterior segment of the eye, the incidence of vitreous hemorrhage is high. Instant eyeball deformation caused by blunt contusion can cause retinal choroidal rupture and vitreous hemorrhage; anterior vitreous hemorrhage can be caused by ciliary body injury.

Spontaneity

Spontaneous vitreous hemorrhage is more common, including inflammatory, degenerative, or neoplastic diseases of the retinal choroid. Some hematological diseases such as leukemia and retinal schizophrenia can also cause vitreous hemorrhage, but it is rare.

3. Diabetic retinopathy

In patients with diabetic retinopathy, the appearance of new blood vessels in the fundus may cause vitreous hemorrhage. Hemorrhage can cause vision loss, and some patients cannot recover by blood self-absorption.

4. Surgical

Surgical vitreous hemorrhage can be seen in cataract surgery, retinal detachment repair surgery, vitreous surgery and so on.

Clinical manifestations of vitreous hemorrhage

The symptoms, signs, prognosis and complications of this disease mainly depend on factors such as the primary disease causing the disease, the amount of bleeding, and the number of bleedings. Spontaneous hemorrhage often occurs suddenly. It can be a small amount of blood, and many form dense blood clots. When there is a small amount of blood, the patient may not be aware of it, or there is only flying mosquitoes; when more blood is generated, the patient may notice that the shadows in front of the eyes are floating or may be covered by red glass. "Smoke", eyesight significantly decreased. In the ophthalmological examination, when there is less blood accumulation, which will not affect the observation of the slit lamp, red blood cells can be seen in the vitreous gel scaffold, which is a lemon-like dust. A moderate amount of fresh blood can appear as dense black bars. A large amount of blood caused no red light reflection in the fundus. Over time, the blood in the vitreous body diffuses, the color fades, and the vitreous body gradually becomes transparent. The absorption of more blood takes 6 months or more than a year. In the absence of obvious fundus lesions, vision may be fully or largely restored. When the posterior segment of the eye is traumatized with massive vitreous hemorrhage, half of the patients may lose useful vision.

Vitreous hemorrhage

Ultrasound examination has great diagnostic value for this disease, especially when it cannot be seen directly. A small amount of diffuse hemorrhage with a B-mode ultrasound may give negative results because of the lack of an adequate echogenic interface in the vitreous. Ultrasound can determine the degree of trauma and vitreous hemorrhage in the posterior segment of the eye, whether it is associated with retinal detachment and other diseases, and judge the visual prognosis. Repeat the test if necessary.

Vitreous hemorrhage diagnosis

A diagnosis can be made based on the inspection.

Vitreous hemorrhage treatment

Drug treatment

In most cases, spontaneous absorption of vitreous hemorrhage takes 4 to 6 months, although preretinal hemorrhage can spread between days and weeks. Patients without combined retinal detachment and fibrous vascular membrane are generally considered to be observable for 2 to 3 months. If vitreous opacity is not significantly reduced during this period, it is unlikely that spontaneous absorption is slow or completely absorbed. Drug therapy attempts to promote blood absorption. However, no drug has been confirmed to have a positive effect.

2. Physical therapy

Ultrasound is used to treat this disease. Ultrasound can promote the absorption of vitreous membrane. Argon laser has also been used to strike clots in the vitreous body, which can vaporize and dissociate blood clots, rupture red blood cells, enhance the vitality of macrophages, and accelerate the absorption of blood. But it may only be suitable for cases with obvious clots and transparent surrounding media.

3. Surgical treatment

Vitrectomy is most suitable for cases of vitreous hemorrhage caused by ocular trauma (such as contusion, laceration, perforation or rupture).