Prognostic Factors of Vitreous Hemorrhage Secondary to Exudative Age-Related Macular Degeneration

Abstract

PURPOSE: Vitreous hemorrhage (VH) is a rare but serious complication of the eyes with exudative age-related macular degeneration (AMD). This retrospective study was designed to evaluate various clinical factors that may affect the visual prognosis of patients with VH secondary to exudative AMD. DESIGN: Retrospective case study. METHODS: We intensively documented 31 cases of VH secondary to exudative AMD and retrospectively analyzed best-corrected visual acuity (BCVA). All eyes underwent standard pars plana vitrectomy (PPV) for treating VH. Three subgroups were created according to the clinical course and treatment history before the occurrence of VH: (1) Gas group (7 eyes), Pneumatic displacement with SF6 gas performed to treat massive submacular hemorrhage; (2) PDT group (9 eyes), Photodynamic therapy performed to treat exudative AMD; (3) Untreated group (15 eyes), 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 a subgroup analysis, no statistically significant difference was seen among the three subgroups at any time point. We found that the eyes whose fellow eye had exudative AMD showed significantly poor final BCVA compared to the unilateral cases (0.92±0.57 and 1.49±0.72, P=0.02). CONCLUSIONS: PPV can improve visual acuity in the eyes with VH secondary to AMD, although effectiveness is limited. Medical practitioners should be cautious of the visual prognosis, especially in the cases whose fellow eye has exudative AMD.