Spontaneous and traumatic vitreous hemorrhage

The authors sought to provide relevant data regarding the demographic and clinical aspects of spontaneous and traumatic vitreous hemorrhages to guide clinicians in better delineating the expected etiologic patterns of these hemorrhages in an urban environment.

The records of 253 consecutive patients with newly diagnosed vitreous hemorrhage seen in a general eye clinic were selected for retrospective analysis. To minimize selection bias of a tertiary care center, patients who were referred to the clinic by outside ophthalmologists for vitreoretinal consultation or those with a history of recent intraocular surgery, postoperative complications, or loss to follow-up were excluded from study. Demographic, ocular, and general medical variables were tabulated for the 200 patients (230 eyes) who met our inclusion criteria.

Fifty percent of the patients were black, 26% were white, 23% were Hispanic, and 1% was Oriental. The causes of vitreous hemorrhage were proliferative diabetic retinopathy (PDR) (35.2%), trauma (18.3%), retinal vein occlusion (7.4%), retinal tear without a detachment (7.0%), posterior vitreous detachment (6.5%), proliferative sickle retinopathy (5.7%), retinal tear with a detachment (4.8%), subretinal neovascularization from macular degeneration (2.2%), hypertensive retinopathy (1.7%), unknown (2.5%), and other causes (8.7%). Among black patients with spontaneous vitreous hemorrhage, sickle cell retinopathy and retinal vein occlusion were major causes, each accounting for more than 15% of the cases. Systemic hypertension was associated with vitreous hemorrhage from retinal vein occlusion.

The authors propose that despite the wide array of causative factors of vitreous hemorrhage, the evaluation of demographic, ocular, and medical variables can significantly aid clinicians in identifying its etiologic patterns.