Surgical outcomes of vitrectomy for breakthrough vitreous hemorrhage in eyes with exudative age-related macular degeneration.

Abstract

PURPOSE:

To report the outcomes of pars plana vitrectomy in cases with breakthrough vitreous hemorrhage (VH) secondary to exudative age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy. We also investigated the relationship between the preoperative b-mode ultrasonographic findings and the postoperative visual acuity to determine if the ultrasonographic findings can predict the surgical outcome after pars plana vitrectomy.

METHODS:

This was a retrospective, interventional, case series. Twenty eyes of 20 patients were studied. The associations between the pre- and intraoperative factors and the final best-corrected visual acuity (BCVA) were determined. Recombinant tissue-plasminogen activator (tPA) was used in cases with massive hemorrhagic retinal detachment.

RESULTS:

Ten eyes with polypoidal choroidal vasculopathy (PCV), two eyes with choroidal neovascularization (CNV), and eight eyes with an unknown type of AMD were studied. The mean BCVA was 0.73 ± 0.57 logarithm of the minimum angle of resolution (logMAR) units before developing the VH, 2.25 ± 0.45 logMAR units before the surgery, and 1.52 ± 0.87 logMAR units after the surgery. The BCVA improved significantly after the surgery (P = 0.004) but was significantly worse than that before developing the VH (P = 0.012). The cases of PCV had better final BCVA than cases of CNV (P = 0.043, Mann-Whitney test). The preoperative presence of a subretinal elevation at the macula detected by ultrasonography was significantly associated with a poorer final BCVA (P = 0.031).

CONCLUSIONS:

Vitrectomy significantly improved visual function in the eyes with VH associated with exudative AMD. The eyes with PCV and no macular subretinal elevation on ultrasonography had a better visual prognosis.

• Authors: Takehito Iwase, Takayuki Baba, Yuya Saito, Tomohiro Nizawa, Hirotaka Yokouchi, Mariko Kubota-Taniai, Masayasu Kitahashi, Shuichi Yamamoto
• Journal: International ophthalmology (Int Ophthalmol) Vol. 41 Issue 5 Pg. 1835-1844 (May 2021) ISSN: 1573-2630 [Electronic] Netherlands
• PMID: 33611763 (Publication Type: Journal Article)

Topics

• Fluorescein Angiography
• Humans
• Macular Degeneration
• Retrospective Studies
• Treatment Outcome
• Vitrectomy
• Vitreous Hemorrhage (diagnosis, etiology, surgery)