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Prognostic Factors and Long-term Surgical Outcomes for Exudative Age-related Macular Degeneration with Breakthrough Vitreous Hemorrhage

 Tae Young Kim  ;  Hyun Goo Kang  ;  Eun Young Choi  ;  Hyoung Jun Koh  ;  Sung Soo Kim  ;  Ji Hwan Lee  ;  Min Kim  ;  Suk Ho Byeon  ;  Christopher Seungkyu Lee 
 Korean Journal of Ophthalmology, Vol.34(4) : 281-289, 2020-08 
Journal Title
Korean Journal of Ophthalmology
Issue Date
Macular degeneration ; Prognosis ; Vitrectomy ; Vitreous hemorrhage
Purpose: We sought to evaluate the long-term outcomes for patients with exudative age-related macular degeneration (AMD) undergoing vitrectomy for breakthrough vitreous hemorrhage and to investigate possible prognostic factors.

Methods: Consecutive patients treated at two high-volume referral-based tertiary hospitals between July 2006 and December 2019 were retrospectively reviewed. Surgery was performed using the standard three-port vitrectomy. The primary outcome was the change in best-corrected visual acuity (BCVA) over long-term follow-up, while secondary outcomes included the assessment of possible prognostic factors.

Results: Among 50 eyes from 50 patients included in this study, 23 (46%) were diagnosed with polypoidal choroidal vasculopathy (PCV) and 27 (54%) were diagnosed with neovascular AMD. Preoperative vision at the time of vitreous hemorrhage onset was 20 / 3,027 (logarithm of the minimum angle of resolution [logMAR], 2.18 ± 0.34). At 12 months after surgery, the mean BCVA improved to 20 / 873 (logMAR, 1.64 ± 0.76; p < 0.001). At 24 months, the BCVA was 20 / 853 (logMAR, 1.63 ± 0.75; p < 0.001). Univariate analysis revealed that older age (odds ratio [OR], 0.879; p = 0.007] and the presence of submacular hemorrhage (OR, 0.081; p = 0.022) were factors associated with a poor 2-year visual outcome. Multivariable regression showed that older age (OR, 0.876; p = 0.026) and neovascular AMD (as compared with PCV) (OR, 0.137; p = 0.014) were significant negative factors influencing the 2-year visual outcome. The mean injection interval prior to vitrectomy was 4.53 months, which extended to 27.64 months after vitrectomy (p = 0.028).

Conclusions: Younger age, the absence of submacular hemorrhage, and PCV type were associated with a favorable 2-year visual outcome after vitrectomy for vitreous hemorrhage in patients with exudative AMD. Overall, vitrectomy resulted in improved visual acuity and patients showed a decreased need for anti-vascular endothelial growth factor therapy thereafter.
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Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Hyun Goo(강현구) ORCID logo https://orcid.org/0000-0001-8359-9618
Koh, Hyoung Jun(고형준) ORCID logo https://orcid.org/0000-0002-5932-8516
Kim, Min(김민) ORCID logo https://orcid.org/0000-0003-1873-6959
Kim, Sung Soo(김성수) ORCID logo https://orcid.org/0000-0002-0574-7993
Byeon, Suk Ho(변석호) ORCID logo https://orcid.org/0000-0001-8101-0830
Lee, Christopher Seungkyu(이승규) ORCID logo https://orcid.org/0000-0001-5054-9470
Lee, Ji Hwan(이지환) ORCID logo https://orcid.org/0000-0003-1759-8195
Choi, Eun Young(최은영) ORCID logo https://orcid.org/0000-0002-1668-6452
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