Original ArticlesSurgical treatment of submacular hemorrhage associated with idiopathic polypoidal choroidal vasculopathy☆
Section snippets
Patients and methods
Between December 1995 and March 1998, eight eyes of eight consecutive patients with idiopathic polypoidal choroidal vasculopathy received surgical management of a submacular hemorrhage. The criteria for surgical management of subretinal hemorrhage were the following: (1) thick subretinal hemorrhage involving the center of the macula, (2) no white-yellow clot (organized blood) in the macula, (3) duration of the submacular hemorrhage less than 30 days, (4) no other ocular disease affecting visual
Results
The follow-up period after surgery ranged from 6 to 25 months (mean, 12.6 months). In all five eyes that underwent removal of submacular hemorrhages, most of the subretinal blood was removed at the end of the surgery. On the other hand, in the remaining three eyes that underwent pneumatic displacement of submacular hemorrhages, most of the subretinal blood displaced from the fovea and the subretinal hemorrhage became much thinner in the macula. In four eyes, laser treatment was performed for
Discussion
The natural course of idiopathic polypoidal choroidal vasculopathy is not definitely known because no study of a large series of patients with this disease has been performed. However, the visual prognosis seems to be relatively good. Spaide and associates4 reported that 12 patients had been followed up for a mean of 4.9 years and the final mean visual acuity (20/70) was not significantly different from the initial mean visual acuity (20/60). Moorthy and associates6 also reported that, although
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Visual prognosis of massive submacular hemorrhage in polypoidal choroidal vasculopathy with or without combination treatment
2016, Journal of the Chinese Medical AssociationCitation Excerpt :It can also impede and reduce the effect of treating the underlying PCV because PDT diode lasers may not be able to penetrate the area, and anti-VEGF may not be able to diffuse through the thick blood clot.6–8,13 Finally, because PCV lesions do not necessarily involve the fovea, surgical treatment of submacular hemorrhage may lead to good central vision.16 However, the Submacular Surgery Trial reported disappointing outcomes and high complication rate after submacular surgery.5,7
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This study was supported in part by the Health Sciences Research Grants from the Ministry of Health and Welfare, Tokyo, Japan.