Kawakami Setsuko, Wakabayashi Yoshihiro, Umazume Kazuhiko, Usui Yoshihiko, Muramatsu Daisuke, Agawa Tsuyoshi, Yamamoto Kaori, Goto Hiroshi
Department of Ophthalmology, Tokyo Medical University, Tokyo 160-0023, Japan.
J Ophthalmol. 2021 Nov 2;2021:2963822. doi: 10.1155/2021/2963822. eCollection 2021.
To study long-term clinical outcomes in patients with submacular hemorrhage (SMH) and/or vitreous hemorrhage (VH) associated with neovascular age-related macular degeneration (nAMD) and the real-world clinical situation of adding anti-VEGF therapy after pars plana vitrectomy (PPV).
In this retrospective case series, 25 eyes with SMH and/or VH associated with nAMD were treated by PPV and followed up for at least 24 months. When exudative changes were unresolved or recurred after PPV, additional intravitreal anti-VEGF therapy was given.
The reasons for performing PPV were SMH (8 eyes) and VH (17 eyes) associated with nAMD. Mean best-corrected visual acuity (BCVA) of eyes with SMH improved significantly at 6 months ( < 0.01) and 12 months ( < 0.05) after PPV. Mean BCVA of eyes with VH improved at 1, 3, 6, 12, 18, and 24 months ( < 0.01) and at the final visit ( < 0.05). Post-PPV anti-VEGF therapy was initiated in 6 of 8 (75.0%) eyes with SMH and 7 of 17 (47.1%) eyes with VH. Of the 13 eyes given anti-VEGF therapy after PPV, 11 eyes had anti-VEGF therapy initiated within 10 months after surgery. Dry macula rate after PPV was 50.0% in SMH and 70.6% in VH.
BCVA improved in eyes with SMH at 6 and 12 months after PPV, and the BCVA was maintained until the end of the study. BCVA improved significantly in eyes with VH at all time points after PPV. In eyes undergoing PPV for nAMD, recurrence of exudative changes after 11 months from the initial PPV was rare.
研究与新生血管性年龄相关性黄斑变性（nAMD）相关的黄斑下出血（SMH）和/或玻璃体积血（VH）患者的长期临床结局，以及玻璃体切割术后（PPV）加用抗VEGF治疗的真实临床情况。
在这个回顾性病例系列中，25只患有与nAMD相关的SMH和/或VH的眼睛接受了PPV治疗，并随访至少24个月。当PPV后渗出性改变未消退或复发时，给予额外的玻璃体内抗VEGF治疗。
进行PPV的原因是与nAMD相关的SMH（8只眼）和VH（17只眼）。SMH患者的眼睛在PPV后6个月（<0.01）和12个月（<0.05）时，平均最佳矫正视力（BCVA）显著提高。VH患者的眼睛在1、3、6、12、18和24个月时（<0.01）以及最后一次随访时（<0.05），平均BCVA有所改善。8只SMH眼中的6只（75.0%）和17只VH眼中的7只（47.1%）在PPV后开始进行抗VEGF治疗。在PPV后接受抗VEGF治疗的13只眼中，11只眼在手术后10个月内开始抗VEGF治疗。PPV后干性黄斑发生率在SMH中为50.0%，在VH中为70.6%。
SMH患者的眼睛在PPV后6个月和12个月时BCVA改善，并一直维持到研究结束。VH患者的眼睛在PPV后的所有时间点BCVA均显著改善。在因nAMD接受PPV的眼中，从初次PPV起11个月后渗出性改变复发的情况很少见。
