Submacular Hemorrhage: Visual Outcomes and Prognostic Factors

Area of Science:

• Ophthalmology
• Retinal Diseases
• Vascular Eye Conditions

Background:

• Submacular hemorrhage (SMH) is a serious condition affecting vision.
• Understanding the causes and outcomes of SMH is crucial for patient management.

Purpose of the Study:

• To identify the primary causes of SMH.
• To evaluate visual outcomes and prognostic factors in patients with SMH.

Main Methods:

• Retrospective case review of 98 patients with SMH (≥1 disc diameter).
• Classification of SMH causes into neovascular age-related macular degeneration (nAMD), polypoidal choroidal vasculopathy (PCV), and others.
• Analysis of visual acuity and indocyanine green angiography (ICGA) findings.

Main Results:

• PCV was the most frequent cause (59%), followed by nAMD (31%).
• PCV patients were younger and had larger hemorrhages than nAMD patients.
• Poor visual outcome (>1.0 logMAR at 6 months) was associated with nAMD diagnosis and low initial visual acuity.

Conclusions:

• PCV is the leading cause of SMH in the studied population.
• Indocyanine green angiography (ICGA) is valuable for diagnosing SMH causes.
• Limited visual outcomes are predicted by nAMD and poor initial visual acuity.