Abstract
Purpose :
Currently there are no objective measurements to determine the density of a vitreous hemorrhage (VH). Clinical grading is the gold standard but is subjective and has high variability between observers. Recently we described a novel, objective measurement termed Minimal Image Gain (MIG) that determines the density of the VH based on the amplitude of the ocular ultrasound scan. We have demonstrated that this method has low variability between observers. The purpose of this study was to use MIG in a prospective clinical setting, observing, and comparing the outcome of VHs, hence, to further validate this method.
Methods :
Prospective cohort study of diabetic patients 18 years of age or older, with VH of 1 month or less duration. Patients were observed for 2 months and were divided into three groups: Group 1, spontaneous resolution of VH; Group 2, persistent VH; Group 3, improving VH. Throughout follow-up, patients were observed with ultrasound and measured using MIG at baseline, 4 and 8 weeks. Other measurements included visual acuity and clinical grading of the VH. Groups were compared using non-parametric tests. Correlations were performed between MIG and VA, as well as MIG and clinical grade.
Results :
We studied 30 patients (17 women, 13 men), with a mean age of 58.4 years (standard deviation [SD]: 7.5). VH had a mean duration of 17 days (SD: 10.3, range: 1—30 days). 7 patients were included in group 1; 16 in group 2; and 7 in group 3. Mean MIG at baseline was 52.14 (SD: 10.3), 51.12 (SD: 9.3), and 59.85 (SD: 8.6) for Groups 1, 2, and 3, respectively. Mean MIG at 8 weeks was 63.0 (8.4), 52.68 (9.9), and 61.14 (11.7). Kruskal-Wallis test was not significant for MIG among groups at baseline (P= 0.144). Mann-Whitney test was significant between Group 1 and 2 at 8 weeks (P= 0.033). Pearson correlation between MIG and LogMAR was -0.231 (P= 0.029). Spearman’s rho correlation between MIG and Clinical Opacity was -0.342 (P= 0.001).
Conclusions :
MIG appears to be an objective tool to measure VHs since it can be used to differentiate patients that are improving towards spontaneous resolution from patients that have a persistent VH. It correlates inversely with VA and with clinical grade.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.