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Sawsan R Nowilaty, Maha Alshehri, Nicola G Ghazi; Visual and Anatomical Outcomes Following Nd:Yag Laser Hyaloidotomy for Premacular Hemorrhage. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4485.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the visual and anatomical outcomes of Nd:YAG laser hyaloidotomy in the management of premacular hemorrhage of different etiologies
Retrospective review of 32 eyes diagnosed with premacular hemorrhage secondary to a variety of causes that underwent Nd:YAG laser hyaloidotomy for drainage of the premacular hemorrhage. The presenting Snellen visual acuity, duration of symptoms, Nd: YAG laser parameters as well as postoperative visual acuity and complications were recorded.
Twenty-two patients were males (70 %) and 10 were females (30%). The mean age group was 42 years and the mean duration of the symptoms was 19.24 days. The cause of preretinal hemorrhage was proliferative diabetic retinopathy in 17 eyes (53.13 %), valsalva retinopathy in 7 (21.9 %), laser pointer injury in 6 (18.75%) and ruptured arterial macroaneurysm in 2 (6.25%). Following hyaloidotomy, failure of drainage of premacular hemorrhage into the vitreous cavity occurred in only 2 eyes (6.25%). Visual acuity postoperatively improved in 25 eyes (78.13 %), remained the same in 6 (18.75 %) and worsened in 1 (3.13 %). The mean Snellen visual acuity improved from 20/300 preoperatively to 20/80 postoperatively. Postoperative complications included the development of dense non-clearing vitreous hemorrhage in 4 eyes (12.5 %) as well as RPE changes, internal limiting membrane folds and ERM, each in 1 eye (3.13 %). In total, 6 eyes required vitrectomy: 4 for dense non-clearing vitreous hemorrhage and 2 for failure of drainage of the premacular hemorrhage into the vitreous cavity. Five of these had proliferative diabetic retinopathy as the cause of the premacular hemorrhage.
Nd:YAG laser hyaloidotomy is an effective treatment modality for premacular hemorrhage. For premacular hemorrhage secondary to proliferative diabetic retinopathy, Nd:YAG laser seems to be less effective and vitrectomy may be needed in about a third of such cases.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
Premacular Hemorrhage at Presentation
Premacular Hemorrhage after YAG Hyaloidotomy
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