Bilateral Spontaneous Suprachoroidal Haemorrhage Induced by the Valsalva Manoeuvre: A Challenging Diagnosis

Suprachoroidal haemorrhage (SCH) denotes a pathological entity characterised by the pathologic accumulation of blood within the suprachoroidal space, a virtual compartment between the choroid and the sclera. SCH occurrence, while relatively infrequent, carries substantial clinical significance, and it may develop spontaneously, during or after ophthalmic surgical procedures, or as a sequel to ocular trauma. In the event that postoperative SCH remains undetected and untreated, it can lead to profound visual impairment, potentially culminating in complete vision loss or blindness [1], [2], [3]. It occurs when the vortical veins or the long and/or short ciliary arteries rupture, and its most significant risk factor is hypotony, or the sudden intraocular pressure drops during or after ophthalmic surgery [4], [5]. SCH has also been reported subsequent to ocular trauma, or spontaneously in patients harbouring specific ocular or systemic predisposing risk factors, such as advanced age, atherosclerosis, vascular disease, arterial hypertension, anticoagulation therapy, chronic kidney disease, aphakia, age-related macular degeneration, myopia, and glaucoma [6] [7] [8] [9] [10] [11].