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Joon Hee Cho, Na-Kyung Ryoo, Kwan Hyuk Cho, Kyu Hyung Park, Se Joon Woo, Sang Joon Park; Incidence rate of massive submacular hemorrhage and its risk factors in polypoidal choroidal vasculopathy. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3699.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the cumulative incidence rate of massive submacular hemorrhage(SMH) in polypoidal choroidal vasculopathy(PCV) and analyze its risk factors.
Patients who were diagnosed and confirmed as PCV during the period from May 2003 to May 2014 were included. Concomitant ocular disease, prior treatment for PCV, less than 1 year of follow up period was excluded. Total of 245 patients were enrolled. The time between the date of the initial visit to the clinic with subjective visual symptom and the date of massive SMH occurrence was investigated. Age, hypertension, indocyanine green angiography(ICG) findings such as greatest linear dimension(GLD), size of the largest polyp, cluster shape of polyps and photodynamic treatment(PDT) were reviewed for risk factor analysis. Kaplan-Meier survival analysis was performed and time dependent Cox regression test with univariable was used for risk factor analysis.
Calculated cumulative incidence rate of massive SMH within a year was 2.45%. Additionally, 6.17%, 11.09%, and 29.85% of PCV occurred massive SMH within 3, 5, and 10 years, respectively. Time dependent Cox regression analysis revealed polyps of cluster type had significant association with massive SMH occurrence (HR=1.320(95%CI 1.051-1.659), p=0.017). Proportional hazard ratio of the cluster type was 3.418(95% CI 1.527-7.648, p=0.003) compared to the non-cluster type. Other factors such as age, hypertension, GLD, size of the largest polyp and PDT were not significantly associated with massive SMH.
Eyes with massive SMH from PCV suffer from more severe vision loss than eyes without it. In PCV eyes, the cumulative incidence of massive SMH increases with time and reaches about 30% in 10 years. A cluster type of polyps was the significant risk factor for massive hemorrhage.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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