TY - JOUR
TI - Macular Hemorrhage Due to Age-Related Macular Degeneration or Retinal
Arterial Macroaneurysm: Predictive Factors of Surgical Outcome
AU - Pierre, Mitta
AU - Mainguy, Adam
AU - Chatziralli, Irini
AU - Pakzad-Vaezi,
AU - Kaivon
AU - Ruiz-Medrano, Jorge
AU - Bodaghi, Bahram
AU - Loewenstein, Anat
AU - and Ambati, Jayakrishna
AU - de Smet, Marc D.
AU - Tadayoni, Ramin and
AU - Touhami, Sara
JO - Journal of Clinical Medicine Research
PY - 2021
VL - 10
TODO - 24
SP - null
PB - MDPI
SN - 1918-3003, 1918-3011
TODO - 10.3390/jcm10245787
TODO - age-related macular degeneration; macular hemorrhage; macular hematoma;
treat and extend; prognosis; retinal arterial macroaneurysm; vitrectomy
TODO - Objective: The study aimed to determine the outcomes and prognostic
factors of vitrectomy, subretinal injection of tissue-plasminogen
activator and gas tamponade in macular hemorrhage (MaH) due to
age-related macular degeneration (AMD) or retinal arterial macroaneurysm
(RAM). Methods: The study design utilized a multicentric retrospective
case series design of consecutive patients undergoing surgery between
2014 and 2019. Results: A total of 65 eyes from 65 patients were
included in the study. Surgery was performed after a mean period of 7.1
days. Displacement of MaH was achieved in 82% of the eyes. Mean
best-corrected visual acuity (BCVA) improved from 20/500 to 20/125 at
month(M)1 and M6 (p < 0.05). At M6, BCVA worsening was associated with
an older age at diagnosis (p = 0.0002) and higher subretinal OCT
elevation of MaH (p = 0.03). The use of treat and extend (TE) (OR =
16.7, p = 0.001) and small MaH fundus size (OR = 0.64 and 0.74 for
horizontal and vertical fundus size, p < 0.05) were predictive of a
higher likelihood of obtaining a countable BCVA at M1. Baseline BCVA was
predictive of postoperative BCVA (p < 0.05). Retinal detachment and MaH
recurrence occurred in 3% and 9.3% of cases at M6. Conclusion: MaH
surgery stabilizes or improves BCVA in 85% of cases. Younger age at
diagnosis, better baseline BCVA figures, smaller subretinal MaH height
and use of TE regime were predictive of the best postoperative outcomes.
ER -