Clinical Characteristics and Outcomes of Hyphema in Patients with Sickle Cell Trait: 10-Year Experience at the Wilmer Eye Institute

Tahreem Mir,1 Mustafa Iftikhar,2 Natalie Seidel,2 Michelle Trang,2 Morton F Goldberg,2 Fasika A Woreta2 1Department of Ophthalmology & Visual Science, Yale School of Medicine, New Haven, CT, USA; 2Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USACorrespond...

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Autores principales:	Mir T, Iftikhar M, Seidel N, Trang M, Goldberg MF, Woreta FA
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	hyphema sickle cell trait elevated intraocular pressure Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/56bf5e6eae4848abab47930b7336e80f
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spelling	oai:doaj.org-article:56bf5e6eae4848abab47930b7336e80f2021-12-02T13:02:00ZClinical Characteristics and Outcomes of Hyphema in Patients with Sickle Cell Trait: 10-Year Experience at the Wilmer Eye Institute1177-5483https://doaj.org/article/56bf5e6eae4848abab47930b7336e80f2020-12-01T00:00:00Zhttps://www.dovepress.com/clinical-characteristics-and-outcomes-of-hyphema-in-patients-with-sick-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Tahreem Mir,1 Mustafa Iftikhar,2 Natalie Seidel,2 Michelle Trang,2 Morton F Goldberg,2 Fasika A Woreta2 1Department of Ophthalmology & Visual Science, Yale School of Medicine, New Haven, CT, USA; 2Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USACorrespondence: Fasika A WoretaWilmer Eye Institute, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Wilmer B29, Baltimore, MD 21287, USATel +1 410-955-5650Fax +1 410-614-8496Email fworeta1@jhmi.eduPurpose: To report the clinical characteristics, complications, and outcomes of hyphema in patients with sickle cell trait (SCT).Design: Retrospective case series.Methods: Medical records of SCT patients (confirmed by hemoglobin electrophoresis) presenting with hyphema at the Wilmer Eye Institute over 10 years (January 2008 through December 2017) were reviewed in detail. Data were collected regarding etiology, demographics, clinical course and management. Main outcome measures included intraocular pressure (IOP) and visual acuity (VA).Results: A total of 14 black patients (males: 57%; median age: 20 years) were included in the study with a median follow-up of 4 months (range: 1 week to 6 years). Ten patients had traumatic hyphema with a mean presenting VA of approximately 1.10 logMAR (Snellen equivalent=20/250) and a mean presenting IOP of 40 mmHg. Nine of them required medical intervention to lower IOP, and six of them ultimately required surgical intervention, primarily in the form of anterior chamber paracentesis and/or washout. The mean time to achieve IOP control was 3 days, and the mean final VA was approximately 0.10 logMAR (Snellen Equivalent=20/25). Four patients had non-traumatic hyphema with a mean presenting VA of approximately 1.8 logMAR (Snellen equivalent=20/1260) and a mean presenting IOP of 31 mmHg. Three of them required medical intervention to lower IOP, and two of them ultimately required surgical intervention. Overall, seven patients underwent anterior chamber washout, six needed an anterior chamber paracentesis to lower the IOP, two required tube shunt placement procedures and one patient underwent a trabeculectomy. The mean time to achieve IOP control was 5 days, and the mean final VA was approximately 0.80 logMAR (Snellen equivalent=20/125).Conclusion: Patients with SCT are likely to develop elevated IOP in the setting of hyphema, with a majority requiring one or more surgical interventions to achieve IOP control.Keywords: hyphema, sickle cell trait, elevated intraocular pressureMir TIftikhar MSeidel NTrang MGoldberg MFWoreta FADove Medical Pressarticlehyphemasickle cell traitelevated intraocular pressureOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 4165-4172 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	hyphema sickle cell trait elevated intraocular pressure Ophthalmology RE1-994
spellingShingle	hyphema sickle cell trait elevated intraocular pressure Ophthalmology RE1-994 Mir T Iftikhar M Seidel N Trang M Goldberg MF Woreta FA Clinical Characteristics and Outcomes of Hyphema in Patients with Sickle Cell Trait: 10-Year Experience at the Wilmer Eye Institute
description	Tahreem Mir,1 Mustafa Iftikhar,2 Natalie Seidel,2 Michelle Trang,2 Morton F Goldberg,2 Fasika A Woreta2 1Department of Ophthalmology & Visual Science, Yale School of Medicine, New Haven, CT, USA; 2Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USACorrespondence: Fasika A WoretaWilmer Eye Institute, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Wilmer B29, Baltimore, MD 21287, USATel +1 410-955-5650Fax +1 410-614-8496Email fworeta1@jhmi.eduPurpose: To report the clinical characteristics, complications, and outcomes of hyphema in patients with sickle cell trait (SCT).Design: Retrospective case series.Methods: Medical records of SCT patients (confirmed by hemoglobin electrophoresis) presenting with hyphema at the Wilmer Eye Institute over 10 years (January 2008 through December 2017) were reviewed in detail. Data were collected regarding etiology, demographics, clinical course and management. Main outcome measures included intraocular pressure (IOP) and visual acuity (VA).Results: A total of 14 black patients (males: 57%; median age: 20 years) were included in the study with a median follow-up of 4 months (range: 1 week to 6 years). Ten patients had traumatic hyphema with a mean presenting VA of approximately 1.10 logMAR (Snellen equivalent=20/250) and a mean presenting IOP of 40 mmHg. Nine of them required medical intervention to lower IOP, and six of them ultimately required surgical intervention, primarily in the form of anterior chamber paracentesis and/or washout. The mean time to achieve IOP control was 3 days, and the mean final VA was approximately 0.10 logMAR (Snellen Equivalent=20/25). Four patients had non-traumatic hyphema with a mean presenting VA of approximately 1.8 logMAR (Snellen equivalent=20/1260) and a mean presenting IOP of 31 mmHg. Three of them required medical intervention to lower IOP, and two of them ultimately required surgical intervention. Overall, seven patients underwent anterior chamber washout, six needed an anterior chamber paracentesis to lower the IOP, two required tube shunt placement procedures and one patient underwent a trabeculectomy. The mean time to achieve IOP control was 5 days, and the mean final VA was approximately 0.80 logMAR (Snellen equivalent=20/125).Conclusion: Patients with SCT are likely to develop elevated IOP in the setting of hyphema, with a majority requiring one or more surgical interventions to achieve IOP control.Keywords: hyphema, sickle cell trait, elevated intraocular pressure
format	article
author	Mir T Iftikhar M Seidel N Trang M Goldberg MF Woreta FA
author_facet	Mir T Iftikhar M Seidel N Trang M Goldberg MF Woreta FA
author_sort	Mir T
title	Clinical Characteristics and Outcomes of Hyphema in Patients with Sickle Cell Trait: 10-Year Experience at the Wilmer Eye Institute
title_short	Clinical Characteristics and Outcomes of Hyphema in Patients with Sickle Cell Trait: 10-Year Experience at the Wilmer Eye Institute
title_full	Clinical Characteristics and Outcomes of Hyphema in Patients with Sickle Cell Trait: 10-Year Experience at the Wilmer Eye Institute
title_fullStr	Clinical Characteristics and Outcomes of Hyphema in Patients with Sickle Cell Trait: 10-Year Experience at the Wilmer Eye Institute
title_full_unstemmed	Clinical Characteristics and Outcomes of Hyphema in Patients with Sickle Cell Trait: 10-Year Experience at the Wilmer Eye Institute
title_sort	clinical characteristics and outcomes of hyphema in patients with sickle cell trait: 10-year experience at the wilmer eye institute
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/56bf5e6eae4848abab47930b7336e80f
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Clinical Characteristics and Outcomes of Hyphema in Patients with Sickle Cell Trait: 10-Year Experience at the Wilmer Eye Institute

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