June 2021
Volume 62, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2021
Effects of lens status on vitreous hemorrhage resolution time
Author Affiliations & Notes
  • Ke Zeng
    Boston University School of Medicine, Boston, Massachusetts, United States
  • Howard Cabral
    Biostatistics, Boston University School of Public Health, Boston, Massachusetts, United States
  • Nicole Siegel
    Ophthalmology, Boston Medical Center, Boston, Massachusetts, United States
  • Manju L Subramanian
    Ophthalmology, Boston Medical Center, Boston, Massachusetts, United States
  • Steven Ness
    Ophthalmology, Boston Medical Center, Boston, Massachusetts, United States
  • Xuejing Chen
    Ophthalmology, Boston Medical Center, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Ke Zeng, None; Howard Cabral, None; Nicole Siegel, None; Manju Subramanian, None; Steven Ness, None; Xuejing Chen, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2021, Vol.62, 1079. doi:
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      Ke Zeng, Howard Cabral, Nicole Siegel, Manju L Subramanian, Steven Ness, Xuejing Chen; Effects of lens status on vitreous hemorrhage resolution time. Invest. Ophthalmol. Vis. Sci. 2021;62(8):1079.

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

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Abstract

Purpose : Vitreous hemorrhage is approximated to resolve 1% per day through the trabecular meshwork, but the factors that affect this rate remain unexplored. We performed a retrospective clinical case study to learn how lens status and other factors can affect vitreous hemorrhage (VH) resolution time in proliferative diabetic retinopathy (PDR).

Methods : This is a retrospective analysis of eyes with PDR presenting with acute VH at an academic medical center between May 1, 2015 and December 31, 2019. We gathered information on lens status (phakic and pseudophakic) and other variables including visual acuity, medications, and glaucoma. In the survival analysis, the primary outcome measure was the number of weeks from diagnosis to either ‘resolution’ or ‘progression to surgery’, whichever came first. Kaplan-Meier univariate analysis method was used to estimate resolution time, and log-rank test determined significance. Cox proportional hazard regression modeling was used to determine adjusted hazard ratios and predictor variables.

Results : Among 157 total eyes (100 phakic, 57 pseudophakic), the groups were similar in age (57 v. 64 years), visual acuity at presentation (LogMAR 1.33 v. 1.38), past history of VH (41% v. 43%), and progression to surgery (Log-rank=1.422, df=1, p=.23). The mean resolution time was 33.0±4.1 weeks (95%CI: 25.0-41.0) for pseudophakic eyes compared to 63.4±9.1 weeks (95%CI: 45.7-81.2) for phakic ones, with a significant difference in the survival of VH (Log-rank = 7.78, df=1, p=.007). Multivariate cox regression showed pseudophakic eyes were 2.4 times (95%CI: 1.3-4.6, p =.008) more likely to resolve than phakic eyes. Vision at presentation (p=0.51), blood-thinning medication (p=0.63), age (p=0.50), and glaucoma (p=0.28) were not found to be associated with resolution time.

Conclusions : VH secondary to PDR resolves at twice the rate in pseudophakic eyes compared with phakic ones. VH is removed from the eye through the trabecular meshwork, so it is possible that being pseudophakic offers an enhanced pathway around the zonules for red blood cells to travel the posterior segment to the anterior chamber. Being able to account for factors that affect VH resolution better guides patient expectations and decisions on surgery.

This is a 2021 ARVO Annual Meeting abstract.

 

Figure 1. Survival analysis of vitreous hemorrhage resolution by lens status

Figure 1. Survival analysis of vitreous hemorrhage resolution by lens status

 

Table 1. Cox proportional hazard model predicting vitreous hemorrhage resolution time (N=157, 56 resolved, 101 censored)

Table 1. Cox proportional hazard model predicting vitreous hemorrhage resolution time (N=157, 56 resolved, 101 censored)

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