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February 1987

Fluorouracil and Suprachoroidal Hemorrhage-Reply

Arch Ophthalmol. 1987;105(2):169. doi:10.1001/archopht.1987.01060020023010

In Reply.  —We have characterized delayed nonexpulsive suprachoroidal hemorrhage (DNSH) as a complication that is most likely to occur when several predisposing factors act in concert.1 We did not suggest that fluorouracil is a factor sufficient by itself or necessary but suspected it to be only one of many possible factors predisposing or contributing to DNSH.We have no evidence to believe that this drug exerts direct toxic vascular effect causing DNSH. Rather, we think that by inhibiting fibroblastic activity it interferes with wound healing, and when combined with antifibroblastic and anti-inflammatory effects of corticosteroids and excessive filtration, with or without conjunctival wound leak, may result in prolonged hypotony and serous choroidal detachment, thereby increasing the chance of DNSH when other predisposing factors coexist. Ruderman et al2 similarly mentioned this phenomenon. If fluorouracil had not been used, would all eight patients of Gressel et al3 still have

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