Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Retina. 2012 Apr;32(4):652-7. doi: 10.1097/IAE.0b013e318233abb4.
To describe the incidence, risk factors for, and long-term visual outcomes of recurrent submacular hemorrhage in the context of age-related macular degeneration.
Medical records of patients with neovascular age-related macular degeneration with or without polypoidal choroidal vasculopathy showing submacular hemorrhage at their first visit to our institution were reviewed. The required minimum follow-up period was 24 months, and any newly developed submacular hemorrhage larger than 1 disk area after near-complete resolution of initial hemorrhage was defined as recurrence.
A total of 47 eyes of 47 patients were eligible for inclusion. Twenty-four patients showed recurrent submacular hemorrhage during the follow-up period (Group I). Patients without recurrent submacular hemorrhage were included in Group II. The time to recurrent submacular hemorrhage in Group I patients was 21.4 ± 9.2 months. Polypoidal choroidal vasculopathy was present in 50% of Group I patients (n = 12) and 13% of Group II patients (n = 3) (P = 0.025). Intravitreal anti-vascular endothelial growth factor injection was performed during the follow-up period in 70.8% of Group I patients (n = 17) and 95.7% of Group II patients (n = 22) (P = 0.048). Visual acuity change during the follow-up period did not significantly differ between the two groups.
In patients with neovascular age-related macular degeneration presenting with submacular hemorrhage at their first visit, the incidence of recurrent submacular hemorrhage was 51.1% in our retrospective long-term follow-up study. The presence of polypoidal choroidal vasculopathy was associated with an increased risk of recurrent submacular hemorrhage. Use of anti-vascular endothelial growth factor agents was correlated with a reduced risk of such hemorrhage. Visual acuity was stably maintained over 2 years regardless of hemorrhage recurrence.
描述年龄相关性黄斑变性脉络膜新生血管患者初次就诊时发生的黄斑下出血的复发率、相关风险因素和长期视力结果。
对在我院初次就诊时患有新生血管性年龄相关性黄斑变性且伴有或不伴有息肉样脉络膜血管病变的黄斑下出血患者的病历进行回顾性分析。所需的最低随访时间为 24 个月，任何在初次出血基本吸收后新出现的大于 1 个视盘面积的黄斑下出血均定义为复发。
共有 47 名患者的 47 只眼符合入选标准。24 只眼在随访期间发生黄斑下出血复发（第 1 组）。无黄斑下出血复发的患者纳入第 2 组。第 1 组患者黄斑下出血复发的时间为 21.4 ± 9.2 个月。第 1 组中有 50%（n = 12）的患者存在息肉样脉络膜血管病变，而第 2 组中有 13%（n = 3）的患者存在息肉样脉络膜血管病变（P = 0.025）。在随访期间，第 1 组中有 70.8%（n = 17）的患者接受了玻璃体内抗血管内皮生长因子注射，而第 2 组中有 95.7%（n = 22）的患者接受了玻璃体内抗血管内皮生长因子注射（P = 0.048）。两组患者在随访期间的视力变化无显著差异。
在初次就诊时伴有黄斑下出血的新生血管性年龄相关性黄斑变性患者中，我们的回顾性长期随访研究显示，黄斑下出血的复发率为 51.1%。息肉样脉络膜血管病变的存在与黄斑下出血复发的风险增加相关。抗血管内皮生长因子药物的使用与出血复发风险的降低相关。无论是否发生黄斑下出血复发，视力在 2 年内均保持稳定。
