Spontaneous retrobulbar haemorrhage associated with anticoagulants

Authors

  • M.J. Vicente Altabás Servicio de Oftalmología Hospital Universitario Miguel Servet. Zaragoza. España.
  • M. Romero Sanz Servicio de Oftalmología Hospital Universitario Miguel Servet. Zaragoza. España.
  • B. Arias-Peso Servicio de Oftalmología Hospital Universitario Miguel Servet. Zaragoza. España.
  • L. Arias Campo Servicio de Oftalmología Hospital Universitario Miguel Servet. Zaragoza. España.
  • M.A. Vicente Altabás Servicio de Medicina Interna Hospital Clínico Universitario Lozano Blesa. Zaragoza. España
  • S. Méndez Martínez Servicio de Oftalmología Hospital Universitario Miguel Servet. Zaragoza. España.

DOI:

https://doi.org/10.23938/ASSN.0972

Keywords:

Retrobulbar haemorrhage, Ophthalmological emergency, Anticoagulants, Loss of visión, Canthotomy

Abstract

Retrobulbar hemorrhage consists of bleeding in the retroseptal intraorbital region generating an orbital compartment syndrome.

We present the case of an 86-year-old woman who came to the Emergency Room due to ocular pain and loss of vision in the left eye of six hours of evolution. The only medical history was atrial fibrillation on anticoagulant treatment with Dabigatran 300 mg daily. The clinical examination was compatible with retrobulbar hemorrhage and the urgent CT confirmed the diagnosis, performing immediately after a canthotomy with cantolysis. In the absence of triggering factors, an orbital MRI was performed which ruled out the existence of arteriovenous malformations, diagnosing spontaneous retrobulbar hemorrhage associated with the use of anticoagulants.

The uniqueness of this case is that it forms part of the small percentage of retrobulbar hemorrhages that are not associated with trauma or postsurgical causes, as well as in illustrating a very rare location of bleeding associated with anticoagulation.

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References

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BERG BI, FLURY E, THIERINGER FM, AUGELLO M, SAVIC M, SCHÖTZAU A et al. Retrobulbar haematoma in the era of anticoagulants. Injury. 2019; 50: 1641-1648. https://doi.org/10.1016/j.injury.2019.08.035

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BAILEY LA, VAN BRUMMEN AJ, GHERGHEREHCHI LM, CHUANG AZ, RICHANI K, PHILLIPS ME. Visual outcomes of patients with retrobulbar hemorrhage undergoing lateral canthotomy and cantholysis. Ophthalmic Plast Reconstr Surg. 2019; 35: 586-589. https://doi.org/10.1097/IOP.0000000000001401

Published

2022-04-27

How to Cite

1.
Vicente Altabás M, Romero Sanz M, Arias-Peso B, Arias Campo L, Vicente Altabás M, Méndez Martínez S. Spontaneous retrobulbar haemorrhage associated with anticoagulants. An Sist Sanit Navar [Internet]. 2022 Apr. 27 [cited 2025 Dec. 21];45(1):e0972. Available from: https://recyt.fecyt.es/index.php/ASSN/article/view/89288

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