[Resorption of post-traumatic cilio-choroid (supra-choroid, sub-scleral) hematoma. A histopathologic study]

The healing process of ciliochoroidal (suprachoroidal, subscleral) hematomas was studied histopathologically in 75 eyes enucleated between 1 and 42 days following a traumatic incident. The ciliochoroidal hematomas occur from ruptured vortex veins or ciliary blood vessels located in the suprachoroidal (subscleral) space. Detached ciliary blood vessels and nerves form a network within the hematoma. In early stages there is little fibrin formation and no signs of coagulation are visible. Then hyperemia of uveal blood vessels develops, followed by a perivascular accumulation of polymorphonuclear leukocytes and lymphocytes with edema. About 11 days after the traumatic event a thin mesenchymal cell layer covers the outside of the hematoma, which at this stage shows some hemolysis. After 2 weeks proteinaceous exudate with lipid vacuoles is present and fibroblastic activity is increased on the uveal side of the hematoma and along the septating blood vessels and nerves. After 3 weeks the outer uvea is impregnated by phagocytic cells containing hemosiderin (hemosiderophages). Twenty-eight days after trauma the fibrous lining of the hematoma has increased. In principle a seroma with septum formation has evolved from the suprachoroidal hematoma. This is regarded as a complicated healing process, which hinders surgical drainage of long-standing post-traumatic hemorrhagic ciliochoroidal detachment and therapy of post-traumatic ocular hypotony.