Peripheral Polypoidal Choroidal Neovascularization, Subretinal Hemorrhage, and Cataract Surgery

In Brief Background: Spontaneous choroidal hemorrhages during uneventful cataract surgery are rare, potentially disastrous, and poorly understood. We describe three patients with spontaneous limited peripheral choroidal hemorrhages and associated polypoidal choroidal neovascularization. Method: Case series. Results: Peripheral polypoidal choroidal vasculopathy was identified as an underlying potential causative factor in these patients with spontaneous limited choroidal hemorrhage during uneventful cataract surgery. Conclusion: Polypoidal choroidal vasculopathy, known to occur in the peripheral fundus, may be a mechanism for spontaneous limited or explosive peripheral fundus subretinal hemorrhages at the time of anterior segment surgery. These hemorrhages may not require interventional treatment in that regression of the associated neovascularization and resolution of the serosanguineous manifestations may occur without significant vision loss. Three patients had large peripheral subretinal hemorrhages during or immediately after uneventful cataract surgery. Polypoidal choroidal vasculopathy was identified as the underlying cause. The hemorrhages resolved spontaneously with a good visual outcome.