What Happens After Prolonged "Kissing" Choroidals?

Purpose: To present a case of long-term kissing choroidals in a patient following a glaucoma shunt procedure and to review related literature. Materials and Methods: An 82-year-old patient developed hemorrhagic kissing choroidals after undergoing a glaucoma procedure. Due to underlying cardiac issues, he was unable to undergo choroidal drainage within the typical 2-3-week window, as he required continued anticoagulant therapy-likely a contributing factor to the complication. Instead, the patient was monitored for six months without intervention, during which moderate proliferative vitreoretinopathy (PVR) developed. Once operable, the patient underwent PVR repair with silicone oil tamponade. A review of relevant medical literature was conducted. Results: The long-term choroidal detachment resolved, and the resultant PVR was successfully repaired with a favorable anatomic outcome. However, visual acuity remained unchanged due to the glaucomatous optic atrophy. Literature review indicates that standard management recommends drainage of kissing choroidals within 2-4 weeks to prevent adhesion of opposing retinal surfaces. However, cases of spontaneous resolution with notable visual recovery have also been reported. Conclusion: While surgical drainage within 2-4 weeks is recommended to reduce the risk of PVR formation, long-standing kissing choroidals may still achieve significant anatomic and/or visual recovery, with or without intervention. The optimal timing for surgical management should be determined on a case-by-case basis, considering the patient's systemic condition.