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Subretinal hemorrhage management by pars plana vitrectomy and internal drainage
E C Wade1, H W Flynn, K R Olsen
1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami School of Medicine, FL 33101.
Archives of Ophthalmology (Chicago, Ill. : 1960)
|July 1, 1990
Summary
Surgical drainage of subretinal hemorrhage offers potential for vision recovery in retinal detachment cases. However, outcomes for age-related macular degeneration patients with massive hemorrhage remain poor, often leading to significant vision loss.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Vitreoretinal Diseases
Background:
- Subretinal hemorrhage (SRH) poses a significant challenge in ophthalmology, particularly when involving the macula.
- Surgical intervention is sometimes considered for SRH, but outcomes vary depending on the underlying cause.
Purpose of the Study:
- To evaluate the surgical outcomes of pars plana vitrectomy and internal subretinal hemorrhage drainage for macular SRH.
- To compare results between SRH secondary to retinal detachment and massive SRH associated with age-related macular degeneration.
Main Methods:
- Retrospective review of 14 consecutive cases undergoing pars plana vitrectomy and internal SRH drainage.
- Cases were divided into two groups: Group 1 (retinal detachment-related SRH) and Group 2 (age-related macular degeneration-related SRH).
Main Results:
- In Group 1 (9 eyes), 8 achieved reattachment with final visual acuity of 20/400 or better; 5 experienced recurrent detachment.
- In Group 2 (5 eyes), all had final visual acuity of 5/200 or worse, with 2 developing marked subretinal fibrosis.
Conclusions:
- Pars plana vitrectomy with internal drainage can be effective for SRH associated with retinal detachment, achieving good visual acuity in most cases.
- Surgical management of massive SRH in age-related macular degeneration is associated with poor visual outcomes and high rates of fibrosis.