Iyer Prashanth G, Brooks H Logan, Flynn Harry W
Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA.
Southern Vitreoretinal Associates, Tallahassee, FL, USA.
Clin Ophthalmol. 2021 Mar 18;15:1189-1192. doi: 10.2147/OPTH.S300662. eCollection 2021.
Submacular hemorrhage (SMH) has been reported to be toxic to the retina based on animal studies. However, observational studies of patients with neovascular-related SMH and those treated with intravitreal anti-vascular growth factor (anti-VEGF) therapy have shown many favorable visual acuity outcomes. We report two cases of neovascular-related SMH with ten or more years of follow-up. The first case was an 83-year old female with a history of nonexudative age-related macular degeneration in both eyes presenting with sudden decrease in vision (20/400) in her right eye due to a large SMH, treated with anti-VEGF therapy. Over the next following months, there was resolution of the hemorrhage and return of good visual acuity. At 10-year follow-up, visual acuity was 20/30 in the right eye. The second case was a 49-year old female with a history of presumed ocular histoplasmosis syndrome (POHS), presenting with sudden vision loss (20/400) in her right eye due to large, thick SMH. With observation and intermittent anti-VEGF therapy, there was resolution of the hemorrhage. At 30-year follow-up, visual acuity was 20/20 in the right eye.
根据动物研究报告，黄斑下出血（SMH）对视网膜具有毒性。然而，对新生血管相关SMH患者和接受玻璃体内抗血管生成因子（抗VEGF）治疗的患者的观察性研究显示，许多患者的视力预后良好。我们报告两例新生血管相关SMH患者，随访时间超过十年。第一例是一位83岁女性，双眼有非渗出性年龄相关性黄斑变性病史，右眼因大面积SMH导致视力突然下降（20/400），接受了抗VEGF治疗。在接下来的几个月里，出血消退，视力恢复良好。在10年随访时，右眼视力为20/30。第二例是一位49岁女性，有疑似眼组织胞浆菌病综合征（POHS）病史，右眼因大面积、厚厚的SMH导致突然视力丧失（20/400）。通过观察和间歇性抗VEGF治疗，出血得到消退。在30年随访时，右眼视力为20/20。
