June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Clinical outcomes of retinal arterial macroaneurysms with vitreous hemorrhage managed with observation versus anti-VEGF versus pars plana vitrectomy
Author Affiliations & Notes
  • Sophia Shinsee Lam
    Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, Pennsylvania, United States
  • Abtin Shahlaee
    Mid Atlantic Retina, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Mirataollah Salabati
    Mid Atlantic Retina, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Michael Klufas
    Mid Atlantic Retina, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Sophia Lam None; Abtin Shahlaee None; Mirataollah Salabati None; Michael Klufas Genentech, Allergan, Code C (Consultant/Contractor), RegenexBio, Code C (Consultant/Contractor), Regeneron, Code S (non-remunerative)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 1747 – F0207. doi:
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      Sophia Shinsee Lam, Abtin Shahlaee, Mirataollah Salabati, Michael Klufas; Clinical outcomes of retinal arterial macroaneurysms with vitreous hemorrhage managed with observation versus anti-VEGF versus pars plana vitrectomy. Invest. Ophthalmol. Vis. Sci. 2022;63(7):1747 – F0207.

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

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Abstract

Purpose : To evaluate the clinical outcomes of retinal arterial macroaneurysm (RAM) with vitreous hemorrhage (VH).

Methods : Retrospective analysis of eyes with RAM and VH seen between July 2013 and October 2021. Clinical and demographic data were reviewed including best corrected Snellen visual acuity (BCVA), treatment, comorbidities, and anticoagulation use. Treatment options included observation, intravitreal anti-VEGF injections (IVI), and pars plana vitrectomy (PPV). Patients with other retinal vascular pathologies requiring treatment were excluded.

Results : Of 50 eligible eyes analyzed, 33 underwent observation, 5 received IVI, and 12 underwent PPV. The mean number of injections in IVI group was 3.6±2.8 (range, 1-8). In IVI group, 100% were treated with bevacizumab. The incidence of subretinal hemorrhage was 18.2% in observation group, 25.0% in surgery group of which 8.3% had treatment with subretinal TPA, and 60.0% in IVI group. The mean time to intervention was 13±15.3 days for PPV and 38±69.9 days for IVI. There was no significant difference in age, gender, lens status, final BCVA, and duration of follow-up between the three groups (Table 1). All eyes showed a significant improvement in BCVA, but IVI and PPV groups had worse presenting BCVA and greater visual improvements compared to the observation group. There was no correlation between the number of injections and final BCVA (r=0.13, p=0.83). IVI and PPV groups used significantly more anticoagulants than observation group. However, there was no significant difference in final BCVA between patients using anticoagulant agents (0.52±0.53, Snellen 20/68) compared to those who were not (0.55±0.65, Snellen 20/71, p= 0.87).

Conclusions : Patients with RAM and VH are elderly and demonstrated significantly improved BCVA from baseline in all treatment groups and similar final visual outcomes. Improved BCVA was not impacted by the number of injections or anticoagulant use, suggesting that these factors may play a less important role in the treatment of RAM with VH.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

 

Table 1. Comparative analysis between observation, anti-VEGF injections, and pars plana vitrectomy in eyes with RAM and VH

Table 1. Comparative analysis between observation, anti-VEGF injections, and pars plana vitrectomy in eyes with RAM and VH

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