What factors should be considered when deciding the best timing for choroidal drainage in a monocular patient with a suprachoroidal hemorrhage and a concurrent retinal detachment?
Answer from: at Community Practice
Reason for the suprachoroidal hemorrhage, size, duration, nature of the retinal detachment, and other coexisting conditions are some factors to consider. A therapeutic level of coumadin, use of antiplatelet medications are fine; clearly a greatly elevated INR is a contraindication. Some surgeons mig...
Another useful adjunct while waiting for drainage is the usage of relatively high-dose oral prednisone. You could consider doing a taper of 60 mg, 40 mg, 20 mg for five days each. As always, ensure there are no contraindications with regard to history of stomach ulcers, mental status change, uncontr...
In these cases, the most important and sometimes most difficult thing is determining whether the retinal detachment is exudative or rhegmatogenous. This will affect the decision-making process regarding when to operate. If it's rhegmatogenous, you may need to operate sooner than would be optimal for...