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

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 sulfur hexafluoride gas performed to treat massive submacular hemorrhage; (2) photodynamic therapy (PDT) group (9 eyes), PDT 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 (logarithm of the minimal angle of resolution). After the occurrence of VH, BCVA before PPV dropped to 2.61 ± 0.82. After the operation, final BCVA improved significantly to 1.25 ± 0.73 (P< 10⁻⁸). In a subgroup analysis, no statistically significant difference was seen among the 3 subgroups at any time point. We found that the eyes whose fellow eye had exudative AMD showed significantly poor final BCVA compared with the unilateral cases (0.92 ± 0.57 and 1.49 ± 0.72; P = .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 in which the fellow eye has exudative AMD.