Kunavisarut Paradee, Thithuan Tipparut, Patikulsila Direk, Choovuthayakorn Janejit, Watanachai Nawat, Chaikitmongkol Voraporn, Pathanapitoon Kessara, Rothova Aniki
Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Department of Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands.
Asia Pac J Ophthalmol (Phila). 2018 Mar-Apr;7(2):109-113. doi: 10.22608/APO.2017389. Epub 2017 Oct 23.
To describe causes, visual outcomes, and prognostic factors in patients with submacular hemorrhage (SMH).
Retrospective case review.
We performed a retrospective review of SMH with a size of at least 1 disc diameter. SMH causes were classified into 3 groups: 1) neovascular age-related macular degeneration (nAMD), 2) polypoidal choroidal vasculopathy (PCV), and 3) other miscellaneous causes.
Ninety-eight eyes of 98 patients were included. Based on clinical presentation and indocyanine green angiography (ICGA), the diagnoses of PCV (59%), nAMD (31%), and miscellaneous other causes (10%) were made. PCV patients were younger (P = 0.005) and had larger SMH size than nAMD patients (P = 0.008). Poor visual outcome [>1.0 logarithm of the minimum angle of resolution (logMAR)] at 6 months was associated with low initial visual acuity (VA; >1.0 logMAR; P = 0.002) and with the diagnosis of nAMD (P = 0.02). In addition, limited visual outcomes were noted for patients older than 65 years and those with persistent SMH for at least 2 months.
PCV was the most common cause of SMH in Thailand. ICGA represented a valuable tool for the diagnosis. Visual outcomes were limited for patients with nAMD and for patients who presented with poor initial VA.
描述黄斑下出血（SMH）患者的病因、视力预后及预后因素。
回顾性病例研究。
我们对大小至少为1个视盘直径的SMH进行了回顾性研究。SMH病因分为3组：1）新生血管性年龄相关性黄斑变性（nAMD），2）息肉状脉络膜血管病变（PCV），3）其他杂类病因。
纳入98例患者的98只眼。根据临床表现和吲哚菁绿血管造影（ICGA），做出PCV（59%）、nAMD（31%）和其他杂类病因（10%）的诊断。PCV患者比nAMD患者年轻（P = 0.005），SMH面积更大（P = 0.008）。6个月时视力预后差[最小分辨角对数（logMAR）>1.0]与初始视力低（VA；>1.0 logMAR；P = 0.002）及nAMD诊断相关（P = 0.02）。此外，65岁以上患者及SMH持续至少2个月的患者视力预后有限。
PCV是泰国SMH最常见的病因。ICGA是一种有价值的诊断工具。nAMD患者及初始视力差的患者视力预后有限。
