Clinical characteristics of and treatment trends for submacular hemorrhage: a retrospective multicenter survey in Japan

Abstract

Purpose : To determine the current clinical characteristics and the trends in treatment for submacular hemorrhage (SMH) in Japan.

Methods : The inclusion criteria were subfoveally involved SMH more than 2 optic discs in area, followed for at least 2 months. One hundred eighty-four (184) eyes of 184 patients (104 men and 80 women) were enrolled from 10 hospitals. The characteristics of SMH were classified by the FLATCAPS classification. Causes, selected treatments, and pre- and post-treatment best-corrected visual acuity (BCVA) were analyzed.

Results : The patients’ mean age was 76.1 ± 9.2. SMH was caused by retinal arterial macroaneurysm (RAM) in 52 eyes (28%), and by age-related macular degeneration (AMD) in 127 eyes (69%): typical age-related macular degeneration in 26%, polypoidal choroidal vasculopathy (PCV) in 73%, and retinal angiomatous proliferation (RAP) in 1%. SMH was observed in more than two retinal layers in 60% of the RAM group and in the subretinal and sub-RPE spaces in 106 eyes (83%) of the AMD group. The mean period between onset and treatment was 10.9 days in all cases, and more cases underwent vitrectomy in the RAM group than in the AMD group (P < 0.0001). Subretinal tissue plasminogen activator injection was selected for 49% of the vitrectomy cases. Mean BCVA in the AMD group was significantly better than in the RAM group at baseline, 1 month after treatment, and the final visit (P>0.0001, P>0.0026, P>0.0163).

Conclusions : PCV was about twice as frequent as RAM as the cause of SMH. The RAM group included more cases with vitrectomy than the AMD group and showed poor BCVA.

This is a 2021 ARVO Annual Meeting abstract.