Abstract
Abstract: :
Purpose: To determine the incidence and outcome of vitreous hemorrhage following treatment of retinal tears with crossed bridging vessels. Methods: Retrospective, noncomparative, nonconsecutive interventional case series of 147 patients with known retinal tears. The outcomes measured include visual acuity, presence of vitreous hemorrhage at presentation, vitreous hemorrhage following treatment, retinal tear location, surgical intervention and outcome. All retinal tears were treated with laser retinopexy at the time of initial presentation. Results: Eleven eyes of 10 patients ranging in age from 42 to 76 years old were identified as having a bridging vessel crossing a single horseshoe tear. At initial presentation, best–corrected visual acuity was 20/60 or better in 10/11 of eyes. Eight patients had a slight vitreous hemorrhage, one had a severe vitreous hemorrhage, and 2 had no vitreous hemorrhage at presentation. The patient with severe vitreous hemorrhage required immediate surgery for possible retinal detachment. The mean follow–up period was 8 months. Nine of the tears were located between the 10:30 and 2:00 positions, while 2 were at the 6:00 position. Following laser treatment, 6 eyes (55%) developed a vitreous hemorrhage from the bridging vessel. The new hemorrhage occurred at a mean of 6.5 months (range 1–12.5 months). One patient had two recurrences of vitreous hemorrhage, the second one occurring 4 months that required vitrectomy. The patient with severe vitreous hemorrhage requiring immediate surgery developed a recurrent vitreous hemorrhage despite cauterization at the time of surgery. Conclusions: Retinal tears with bridging vessels are associated with a high degree of new vitreous hemorrhage after initial presentation. Patients warrant close attention and need to be instructed that future vitreous hemorrhage may occur, despite laser treatment of the tear. Most vitreous hemorrhages will spontaneously resolve. In eyes requiring vitreous surgery, visual and anatomic outcomes are excellent.
Keywords: retina • vitreous • vitreoretinal surgery