A Case Series of Resolving Vitreous Haemorrhage in the Setting of Diabetic Retinopathy - A Case Series of Resolving Vitreous Haemorrhage in the Setting of Diabetic Retinopathy - Open Access Pub

This case series presents 2 patients (67 and 58 year old females) with resolving vitreous hemorrhage in the setting of diabetic retinopathy. Both patients had around 50% of the retina still visible and the hemorrhage was confined at the posterior vitreous cavity near the retina, hence, a partial pan retinal photocoagulation (PRP) was feasibly applied. On B-scan, both cases showed a liquified vitreous with posterior vitreous detachment (PVD). For both patients, vitreous hemorrhage resolution occurred at less than 4 months from onset and consequently PRP was completed. Vitreous hemorrhage differs with bleeding in other tissues due to the presence of vitreous collagen matrix which promotes rapid clotting and hinders resolution of hemorrhage by preventing passive diffusion and delay in inflammatory cellular response. The prognosis for clearing hemorrhage was better when the fundus reflex was brighter and the retina adjacent to the ora serrata was visible. Clearing occurred sooner when hemorrhage was retrohyaloid rather than in the vitreous gel. In diabetic eye, the vitreous undergoes metabolic derangements resulting in premature liquefaction and abnormal vitreoretinal adhesion leading to traction and membrane formation. Partial PVD has also been associated with higher rate of diabetic retinopathy progression since it serves as scaffold for growth of neovascular tufts. DOI10.14302/issn.2470-0436.jos-19-2904 We are presented with 2 cases of vitreous hemorrhage secondary to proliferative diabetic retinopathy which spontaneously resolved prior to vitrectomy. The purpose of this case series is to discuss on the mechanism of vitreous hemorrhage resolution in the setting of diabetic retinopathy. The 1st case is a 67 year old female with an uncontrolled diabetes for 20 years. Vision at consult was 2/60 on the right and 6/7.5 best corrected visual acuity (BCVA) on the left. Ocular pressure for both eyes were normal. Her right eye had vitreous hemorrhage occupying half of the retina including the macula. Laser photocoagulation was immediately applied on the retinal areas free of hemorrhage. The left eye, on the other hand, had a beginning retinopathy with micoraneurysms and exudates. The patient was on close observation with high back rest and co-management with her endocrinologist for sugar control. Every now and then, laser would be applied to areas of the retina that had been recently uncovered from the receding hemorrhage. She was also advised for vitrectomy if the hemorrhage does not resolve. After 3 months, the hemorrhage resolved and vision improved. At this