Acute iris vascular tuft hemorrhage treated successfully with intravitreal bevacizumab and pressure patching in a patient with branch retinal vein occlusion

PURPOSE: To report the presentation and management of active iris vascular tuft (IVT) hemorrhage and spontaneous hyphema in an eye with previous branch retinal vein occlusion (BRVO). OBSERVATIONS: A 74-year-old male with a history of BRVO in the left eye presented with spontaneous hyphema and blurred vision. Clinical examination confirmed the presence of an actively bleeding IVT at the pupillary margin in the left eye. Sustained hemostasis was achieved following intravitreal bevacizumab injection and pressure patching of the eye. CONCLUSIONS AND IMPORTANCE: This is the first case report to demonstrate pressure patching as a non-invasive, effective method of achieving hemostasis in the acute setting of IVT hemorrhage. Intravitreal vascular endothelial growth factor antagonists such as bevacizumab may also be useful in decreasing the risk of IVT hemorrhage in eyes with chronic ischemia, although further investigation is warranted.