Subretinal hemorrhages secondary to age-related macular degeneration: psychological and vision-related functional...

To assess psychological, visual and functional aspects associated with subretinal hemorrhages secondary to age-related macular degeneration (AMD).

In this prospective, comparative, longitudinal study, 90 eyes of 90 patients with a subretinal hemorrhage, secondary to AMD, of at least 1 disk diameter were treated with recombinant tissue plasminogen activator (rTPA) and gas, and compared to 25 eyes of 25 controls. Outcome measures were: (1) visual acuity, (2) self-reported vision-related quality of life (Visual Function 14-item questionnaire) and (3)Hospital Anxiety and Depression (HAD) scores. Visual acuity and questionnaire responses were recorded prior to as well as 2 weeks and 4 months after treatment.

Improvements across objective visual acuity and vision-related functional measures, assessed at 2 weeks and 4 months, were significantly higher in patients who had rTPA and gas injections than in controls (p < 0.01). Patients were significantly more distressed at their 2-week follow-up in comparison to controls (HAD scores p < 0.01). Comparisons to controls showed no significant difference in psychological scores at the 4-month follow-up (p > 0.32).

Patients with subretinal hemorrhages secondary to AMD are psychologically distressed as a result of acute loss of vision. More attention should be given to strategies that teach patients to cope with acute vision loss and thereby psychological disorder.