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Predictors of Visual Outcomes in Surgically Managed Hemorrhagic Choroidal Detachment
Alexander J Shaer1, Tadashi Yokoi1,2, Taku Wakabayashi1,3
1Retina Service of Wills Eye Hospital, Mid Atlantic Retina, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA.
Retina (Philadelphia, Pa.)
|July 28, 2026
Summary
Early surgery for hemorrhagic choroidal detachment (HCD) was linked to worse visual acuity. Delayed intervention, particularly after clot liquefaction, may improve outcomes without affecting anatomic resolution or retinal detachment risk.
Area of Science:
- Ophthalmology
- Surgical Retina
- Retinal Detachment
Background:
- Hemorrhagic choroidal detachment (HCD) is a serious complication that can lead to vision loss.
- Predicting visual acuity (VA) outcomes after surgical management of HCD is crucial for patient counseling and treatment planning.
Purpose of the Study:
- To identify predictors of visual acuity (VA) after surgical management of hemorrhagic choroidal detachment (HCD).
- To assess the impact of surgical timing and drainage technique on anatomic outcomes and postoperative rhegmatogenous retinal detachment (RRD).
Main Methods:
- Retrospective cohort study of surgically managed HCD eyes.
- Surgical timing categorized as 0-6, 7-14, or ≥15 days from diagnosis.
- Primary outcome: postoperative month-6 best available VA (logMAR); secondary outcomes: HCD resolution and postoperative RRD.
Main Results:
- Mean VA improved from 2.57 to 2.07 logMAR at 6 months post-surgery (p<0.001).
- Early surgery (0-6 days) predicted worse VA outcomes compared to 7-14 days (p=0.008); later surgery (≥15 days) did not significantly differ.
- Worse baseline VA, appositional choroidal detachments, and trauma were associated with poorer VA. Neither timing nor technique affected HCD resolution or RRD risk.
Conclusions:
- Early surgical intervention for HCD may be associated with worse visual outcomes.
- Delayed intervention until clot liquefaction appears safe and does not compromise anatomic resolution or increase RRD risk.
- Trauma-associated HCD represents a higher-risk subgroup requiring careful management.