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PENG SUN, Feng Gu, Han Zhang, Zheli Liu; Vitrectomy With or Without Drainage of Subretinal Hemorrhage for Breakthrough Vitreous Hemorrhage Secondary to Polypoidal Choroidal Vasculopathy. Invest. Ophthalmol. Vis. Sci. 2019;60(9):370.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the long-term therapeutic effect of pars plana vitrectomy (PPV) for breakthrough hemorrhage secondary to polypoidal choroidal vasculopathy (PCV) and the outcome difference between vitrectomy with drainage of massive subretinal hemorrhage and simple vitrectomy.
This consecutive retrospective study included 62 patients (62 eyes) with vitreous hemorrhage and hemorrhagic retinal detachment. All patients were treated with vitrectomy and diagnosed with PCV during the operation. 33 patients (33 eyes) underwent drainage of subretinal hemorrhage using retinectomy and gas/silicone oil tamponade (drainage group). 29 patients (29 eyes) were treated with simplified operation without any subretinal maneuver or tamponade (simple PPV group). Intravitreal anti-VEGF and/or photodynamic therapy (PDT) was administrated during the follow-up according to the activity of choroidal lesions. Postoperative best corrected visual acuity (BCVA), intraocular pressure, optical coherence tomography (OCT) were performed for statistical analysis.
All patients were followed up average 16.3 months (12-24 months). At 12 months follow-up, LogMAR of BCVA was 1.58±0.75 in drainage group, and 0.79±0.61 in simple PPV group (p<0.001). The central retinal thickness (CRT) of drainage group and simple PPV group were 317±93 mm and 355±110mm respectively (p=0.131). Five patients (15.2%) in drainage group experienced postoperative hyphema and two patient (6%) developed secondary glaucoma. Four patients (12.1%) in drainage group developed proliferative vitreoretinopathy and cured by another vitrectomy. There was no severe complication in simple PPV group.
Vitrectomy is an effective treatment for the breakthrough vitreous hemorrhage secondary to PCV. Compared with subretinal hemorrhage drainage, simple vitrectomy may achieve better visual outcome and less postoperative complications.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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