Prognostic Factors of Vitreous Hemorrhage Secondary to Exudative Age-Related Macular Degeneration
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PURPOSE: Vitreous hemorrhage (VH) is a rare but serious complication of theeyes with exudative age-related macular degeneration (AMD). This retrospectivestudy was designed to evaluate various clinical factors that may affect the visualprognosis of patients with VH secondary to exudative AMD.DESIGN: Retrospective case study.METHODS: We intensively documented 31 cases of VH secondary to exudativeAMD and retrospectively analyzed best-corrected visual acuity (BCVA). All eyesunderwent standard pars plana vitrectomy (PPV) for treating VH. Three subgroupswere created according to the clinical course and treatment history before theoccurrence of VH: (1) Gas group (7 eyes), Pneumatic displacement with SF6 gasperformed to treat massive submacular hemorrhage; (2) PDT group (9 eyes),Photodynamic therapy performed to treat exudative AMD; (3) Untreated group (15eyes), No treatment performed.RESULTS: As a whole, BCVA before the occurrence of VH was 1.05±0.59(LogMAR). After the occurrence of VH, BCVA before PPV dropped to 2.61±0.82.After the operation, final BCVA significantly improved to 1.25±0.73 (P<10-8). In asubgroup analysis, no statistically significant difference was seen among the threesubgroups at any time point. We found that the eyes whose fellow eye hadexudative AMD showed significantly poor final BCVA compared to the unilateralcases (0.92±0.57 and 1.49±0.72, P=0.02).CONCLUSIONS: PPV can improve visual acuity in the eyes with VH secondary toAMD, although effectiveness is limited. Medical practitioners should be cautious ofthe visual prognosis, especially in the cases whose fellow eye has exudative AMD.
- 2010-02-01