April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
AMD with submacular hemorrhage: new insights from a population-based study
Author Affiliations & Notes
  • Gerard F McGowan
    Ophthalmology, Tennents Inst of Ophthal, Glasgow, United Kingdom
  • David Steel
    Sunderland Eye Infirmary, Sunderland, United Kingdom
  • David Yorston
    Ophthalmology, Tennents Inst of Ophthal, Glasgow, United Kingdom
  • Footnotes
    Commercial Relationships Gerard McGowan, None; David Steel, None; David Yorston, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 662. doi:
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      Gerard F McGowan, David Steel, David Yorston; AMD with submacular hemorrhage: new insights from a population-based study. Invest. Ophthalmol. Vis. Sci. 2014;55(13):662.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract 
 
Purpose
 

To present the findings of a two centre, six month pilot study to determine the incidence of all new fovea involving large submacular haemorrhage

 
Methods
 

We conducted a novel 6 month pilot study in 2 centres, Sunderland and Glasgow (UK) to determine the incidence of all new, fovea involving, large submacular haemorrhages of greater than 2 disc diameters (greatest linear diameter). We collected data on presenting visual acuity, age, duration of symptoms, past ocular history, anticoagulant therapy, smoking status, management and visual outcome at 6 months.

 
Results
 

Estimated Incidence of new large submacular haemorrhage: 25 per million per year. There was a wide range of presenting visual acuity (VA range: 6/9- HM. VA less than 3/60: 14/24, 3/60-6/60: 3/24, 6/60-6/18: 4/24, 6/18 or better: 3/24) age (range 49-92 median: 80), duration of symptoms (range 1-25 days median 9.6 days), past ocular history in affected eye (5/24 wet amd 3/24 dry amd i.e AntiVEGF naïve: 19/24), presence of anticoagulant therapy (9/24, (3 warfarin, 7 aspirin, 1 clopidogrel, 1 diclofenac) smokers (4/24 ex-smokers) and management: 3/24 observed, 9/24 antiVEGF, 6/24 PPV + subretinal tpa+ subretinal antiVEGF+ gas, 2/24 PPV + subretinal tpa + intravitreal antiVEGF + gas, 1/24 PPV + subretinal tpa+ gas, 1/24 expansile gas + intravitreal tpa + intravitreal antiVEGF, 1/24 expansile gas + intravitreal tpa. Vision remained stable or improved in all patients who underwent treatment.

 
Conclusions
 

As far as we are aware, we are the first group to estimate an incidence of new large submacular haemorrhage, 25 per million per year. Our results highlight the wide variety of management. On the basis of these results we secured a grant from the Scottish Ophthalmic Surveillance Unit (SOSU) to determine the true incidence of new large submacular haemorrhage. Scottish Ophthalmic Surveillance Unit: uses a structured, card reporting surveillance system to collect one year data on uncommon ophthalmic conditions in Scotland- study commrnenced November 2013. The cost of antiVEGF therapy is considerable and submacular haemorrhage may be an important cause of treatment failure. Identifying the true incidence of this condition and developing improved treatments has obvious implications for public health and health economics. We believe that this study could be a vital step towards identifying a gold standard treatment for submacular haemorrhage

  
Keywords: 412 age-related macular degeneration • 762 vitreoretinal surgery • 688 retina  
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