Abstract
Purpose :
The presence of Henle's fiber layer hemorrhage (HFLh) in submacular hemorrhage (SMH) caused by retinal arterial macroaneurysm rupture (RAM) has been reported to result in decreased visual acuity after SMH displacement. However, the effect of HFLh on the foveal sensitivity after SMH displacement is unknown. In this study, we investigated the pre- and postoperative effect of HFLh on the foveal sensitivity in the eyes with SMH due to RAM rupture.
Methods :
This was a retrospective observational study. The subjects were 31 eyes of 31 patients who underwent surgical displacement of SMH due to RAM rupture at Okayama University Hospital and were able to be followed up for at least 6 months after the surgery. The presence of HFLh was determined preoperatively using swept source optical coherence tomography (Triton, Topcon). Retinal sensitivity (RS) was measured preoperatively, 6 months postoperatively, and fellow eye using a microperimeter (MAIA; CenterVue). The measurement area was a 10-degree centered on the fovea, and the measurement pattern was a grid pattern of 68 points. Among the measurement points, the mean RS of 4 points (central 2°) and 12 points (central 4°) were compared with and without HFLh.
Results :
HFLh was observed in 21 eyes (68%, HFLh+ group) and not observed in 10 eyes (32%, HFLh- group). Preoperative RS of both central 2° and 4° were not significantly different between the HFLh+ group (15.5 ± 2.3 dB and 17.1 ± 2.2 dB, respectively) and HFLh- groups (17.2 ± 6.9 dB and 17.3 ± 4.5 dB, respectively, P>0.05 for both). Postoperative RS of both central 2° and 4° were significantly worse in the HFLh+ group (22.2 ± 0.5 dB and 23.0 ± 0.6 dB, respectively) than in the HFLh- group (25.4 ± 1.0 dB and 25.0 ± 0.7 dB, respectively, P<0.05 for both). The postoperative RS of both central 2° and 4° of the HFLh+ group were significantly worse than that of the fellow eyes (25.1 ± 0.7 dB and 25.3 ± 0.6 dB, respectively, P<0.05 for both). On the other hand, the postoperative RS of both central 2° and 4° of the HFLh- group were not significantly different from those of the fellow eyes (25.6 ± 0.9 dB, 25.6 ± 0.7 dB, respectively, P>0.05 for both).
Conclusions :
Even with successful SMH displacement, the presence of HFLh significantly reduces postoperative foveal sensitivity.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.