Department of Retina and Vitreous, Narayana Nethralaya, #121/C, 1st R Block, Chord Road, Rajaji Nagar, Bengaluru, 560010, India.
Medical Retina and Vitreoretinal Surgery, University of Pittsburgh School of Medicine, 203 Lothrop Street, Suite 800, Pittsburg, PA, 15213, USA.
BMC Ophthalmol. 2024 Oct 8;24(1):440. doi: 10.1186/s12886-024-03715-z.
To evaluate the baseline characteristics of fundus autofluorescence (FAF) in patients with submacular hemorrhage (SMH).
This retrospective study included patients diagnosed with treatment-naive, foveal-involving subretinal hemorrhage (size > 2-disc diameters) of any etiology, presenting between June 2017 and June 2023. Only cases with good-quality color fundus photographs, optical coherence tomography (OCT) scans, and blue-light FAF images at baseline were included. SMH imaging characteristics were documented and correlated with treatment outcomes. A successful treatment outcome was defined as the reduction, displacement or clearance of the SMH from beneath the fovea.
Nineteen cases of SMH (13 males, 6 females), ranging from 14 to 85 years, were analyzed. Neovascular age-related macular degeneration (nAMD) was the most common etiology (n = 11, 58%). Baseline visual acuity ranged from 6/9 to counting fingers at ½ meter, with a median presentation time of 7 days from symptom onset (range: 1-57 days). Treatment success was observed in 13 eyes (68%). Hypoautofluoroscence on FAF was significantly associated with SMH resolution (p = 0.021). However, no association was found between treatment success and clinical hemorrhage characteristics (p = 0.222), OCT findings (p = 0.222), or specific treatments (p > 0.05). Hypoautofluoroscence on FAF was the sole predictor of treatment success, as demonstrated by Spearman's correlation (r = 0.637; p = 0.003) and linear regression analysis (p = 0.003).
FAF, in conjunction with color fundus photography and OCT, may provide valuable insights for clinicians in formulating treatment strategies for patients with SMH. Hypoautofluoroscence on FAF was a significant predictor of successful SMH resolution in this study.
评估黄斑下出血（SMH）患者的眼底自发荧光（FAF）基线特征。
本回顾性研究纳入了 2017 年 6 月至 2023 年 6 月期间诊断为未经治疗、累及黄斑的任何病因的局限性脉络膜新生血管（大小> 2 个视盘直径）的患者。仅纳入具有良好质量的彩色眼底照片、光学相干断层扫描（OCT）扫描和基线蓝光 FAF 图像的病例。记录 SMH 成像特征并与治疗结果相关联。成功的治疗结果定义为 SMH 从黄斑下减少、移位或清除。
共分析了 19 例 SMH（13 名男性，6 名女性）患者，年龄从 14 岁到 85 岁不等。新生血管性年龄相关性黄斑变性（nAMD）是最常见的病因（n=11，58%）。基线视力从 6/9 到数指距离（半米）不等，中位发病时间为症状出现后 7 天（范围：1-57 天）。13 只眼（68%）观察到治疗成功。FAF 上的低自发荧光与 SMH 消退显著相关（p=0.021）。然而，治疗成功与临床出血特征（p=0.222）、OCT 发现（p=0.222）或特定治疗之间无关联（p>0.05）。FAF 上的低自发荧光是治疗成功的唯一预测因子，这一点通过 Spearman 相关分析（r=0.637；p=0.003）和线性回归分析（p=0.003）得到证实。
FAF 结合彩色眼底摄影和 OCT，可为临床医生制定 SMH 患者的治疗策略提供有价值的信息。在本研究中，FAF 上的低自发荧光是 SMH 成功消退的显著预测因子。
