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J.-J. Lee, H.-K. Kuo, Y.-J. Chen, P.-C. Wu, C.-H. Chen, Y.-H. Chen; Macular Hemorrhage in Patients With Excessive Myopia -- The Studies of Prognostic Factors and the Effect of Weather Change on Incidence. Invest. Ophthalmol. Vis. Sci. 2007;48(13):3692.
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To evaluate the prognostic factors that might affect the long term visual outcome and the influence of weather change on the incidence of acute macular hemorrhage associated with excessive myopia.
We retrospectively reviewed charts, fundus photographs and fluorescein angiographs of 27 excessive myopic eyes (17 OD and 10 OS) of 26 patients (22 women and 5 men) who had macular hemorrhage without any laser treatment during 1992 to 2006. Factors of age, sex, laterality, refractive status, CNV, hemorrhage size, visual acuity at onset, visual acuity 6 months after hemorrhage and duration of follow up were included for analysis with multiple linear regression. The relation between hemorrhage absorption time and final visual outcome are evaluated with rank-test. We also estimate the association between the incidence of the disease and the change of room temperature per months (defined as ΔTN = (TN+1 - TN-1) /2, T= minimum room temperature & N= month from 1 to 12)
The age of patients was 35.0 ± 2.0 (16 to 57). The duration of follow up was 50.4 ± 6.9 (9 to 165 months). The spherical equivalent of refraction status was -10.20 ± 0.70 (-6.0 D to -18.0 D). Choroidal neovascularization (CNV) were recorded in 9 cases. The eyes that regained vision within 6 months had a better final outcome. (Multiple linear regression, P<0.001). Early absorption of hemorrhage correlated with a better final vison (chi-squared test for trend, P = 0.043). The incidence of macular hemorrhage is associated with the change of temperature which is largest in November (Spearman’s test, P= 0.03).
Patients of macular hemorrhage with excessive myopia regained their vision over time especially for patients with earlier hemorrhage absorption and who recuperated vision smoothly within 6 months. CNV is disclosed to be a poor prognostic factor in earlier studies. Nonetheless, our data showed no significant difference. The pattern of changes, instead of exact values, of room temperature matched up that of the incidence of macular hemorrhage. The underlying mechanism is not clearly understood.
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