[Post-laser choroidal hematoma in a diabetic patient treated with an oral anticoagulant]

We report a case of a 45 year old diabetic man treated with insulin who developed a right choroidal hematoma after krypton laser treatment for proliferative retinopathy. This patient had a history of myocardial infarction and had been treated with oral anticoagulants for 3 years. Choroidal hematoma was associated with vitreous hemorrhage and presumed herpetic uveitis. Since the retina could not be visualized the diagnosis was based on ultrasound findings. Irreversible blindness of the affected eye occurred. In this case report, oral anticoagulant treatment seems to be the major risk factor leading to the development of this unusual hemorrhagic complication of panretinal photocoagulation. To avoid this serious accident, patients submitted to long-term oral anticoagulant treatment should be managed with particular caution before and during photocoagulation.