Abstract：
PURPOSE:To examine the visual outcomes of early intervention in the setting of fundus-obscuring vitreous hemorrhage (VH) presumed to be due to posterior vitreous detachment. DESIGN:Retrospective comparative case series. METHODS:All eyes that presented with a fundus-obscuring VH, defined as vision of 20/400 or worse and requiring a B-scan at presentation from 2003 to 2013, were evaluated. Eyes with any history of retinopathy, macular degeneration, recent trauma, presentation greater than 2 weeks after onset of symptoms, or follow-up of less than 2 months were excluded. The main outcome measure studied was final best-corrected visual acuity (BCVA) as dependent on the time to surgery. RESULTS:Ninety-two eyes met inclusion criteria with a mean follow-up of 490 days. Initial BCVA was logMAR 2.218 (Snellen equivalent 20/3000-20/4000, range 20/400-light perception); final BCVA was 0.318 (Snellen equivalent of 20/40-20/50, range 20/20-light perception, P < .001). Fifty-six patients (60.8%) had either a retinal tear or a retinal detachment. Patients who underwent surgery within 1 week had no significant improvement over all others; however, a significant improvement was found when comparing early vs delayed surgery groups (P < .05). There was a significantly increased risk of developing a macula-off retinal detachment in patients who did not undergo surgery within 1 week of presentation. CONCLUSIONS:Early surgical intervention results in similar visual outcomes compared to a conservative approach. However, early intervention significantly reduces the incidence of severe vision loss related to macula-involving retinal detachment. This study highlights the importance of close follow-up given the high risk of retinal detachment in fundus-obscuring vitreous hemorrhage.
journal_name
Am J Ophthalmoljournal_title
American journal of ophthalmologyauthors
Melamud A,Pham H,Stoumbos Zdoi
10.1016/j.ajo.2015.07.025subject
Has Abstractpub_date
2015-11-01 00:00:00pages
1073-1077.e1issue
5eissn
0002-9394issn
1879-1891pii
S0002-9394(15)00449-3journal_volume
160pub_type
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pub_type： 杂志文章
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journal_title：American journal of ophthalmology
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更新日期：2018-02-01 00:00:00
