Long‐term visual outcomes for treatment of submacular haemorrhage secondary to polypoidal choroidal vasculopathy

Kang, Hyun Goo; Kang, Hee-Taik; Byeon, Suk Ho; Kim, Sung Soo; Koh, Hyoung Jun; Lee, Sung Chul; Kim, Min

doi:10.1111/ceo.13198

Cited by 8 publications

(6 citation statements)

References 26 publications

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“…Kang et al compared three treatment methods for SMHs secondary to PCV including intravitreal anti-VEGF monotherapy, pneumatic displacement with anti-VEGF therapy, and pars plana vitrectomy with anti-VEGF therapy, and found little difference in the VAs at 2 years among the three treatments. 12 In the current study, multiple regression analyses showed that neither pneumatic displacement nor anti-VEGF therapy after the development of large SMHs significantly affected the BCVA 1 year later; however, these results may be attributable to the small sample sizes.…”

Section: Discussioncontrasting

confidence: 67%

Visual Outcomes and Prognostic Factors of Large Submacular Hemorrhages Secondary to Polypoidal Choroidal Vasculopathy

Matsuo¹,

Haruta²,

Ishibashi³

et al. 2021

OPTH

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Purpose: Patients with polypoidal choroidal vasculopathy (PCV) may develop large submacular hemorrhages (SMHs), which may result in severe visual loss. This study was performed to determine the visual outcomes and prognostic factors of large SMHs secondary to PCV. Patients and Methods: We retrospectively reviewed the medical records of patients diagnosed with PCV who developed a large SMH. The best-corrected visual acuity (BCVA) data were collected at the SMH development, 1 month, 1 year after the SMH development, and at the final visit. Patients' medical information also were collected and included age, gender, systemic hypertension, current regular use of an anticoagulant or antiplatelet medication, the initial area of the SMH, breakthrough vitreous hemorrhage, ocular treatment, and fellow eye status. Univariate and multiple regression analyses were performed to determine the prognostic factors for the BCVA 1 year after the development of large SMHs. Results: Thirty eyes of 29 patients were included in this study. The mean area of the SMHs at the development was 17.0 disc areas. The mean follow-up period after the development of SMHs was 53.5 months. The mean BCVA at the development, 1 month, and 1 year after the development, and at the final visit were 20/151, 20/263, 20/138, and 20/152, respectively. Multiple regression analyses indicated that a SMH 20 disc areas or larger was a significant negative factor, and the BCVA 1 month after the development was a significant positive factor affecting the BCVA 1 year after the development of large SMHs. Conclusion:The increase in the initial area of SMH was correlated inversely with the BCVA 1 year after the development of SMH. The BCVA 1 month after the development may predict the BCVA 1 year after the development of a large SMH.

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Section: Discussioncontrasting

confidence: 67%

Visual Outcomes and Prognostic Factors of Large Submacular Hemorrhages Secondary to Polypoidal Choroidal Vasculopathy

Matsuo¹,

Haruta²,

Ishibashi³

et al. 2021

OPTH

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“…Overall, at 2 years post‐intervention there was no reported sustained overall difference in BCVA between the three groups . Despite small numbers ( N = 10) the potential for significant visual improvement (three line gain or more) may be more likely with pneumatic displacement.…”

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confidence: 88%

“…In this issue, Kang et al . report a retrospective review of 48 consecutive Korean eyes diagnosed with significant submacular haemorrhage involving the fovea centre secondary to PCV, and describe their outcomes when allocated one of three treatment arms: intravitreal bevacizumab (IVB) alone, IVB with pars plana vitrectomy (PPV) or IVB with pneumatic displacement (PD) . Pathways were allocated by the treating specialist and despite the largest group of those undergoing IVB monotherapy, baseline VA suggest that those with worse vision were significantly more likely to undergo PPV.…”

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confidence: 99%

The needle, or the knife?

Cugley

Fagan

2018

Clinical Exper Ophthalmology

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“…Intravitreal administration of anti-VEGF is one of the effective treatment modalities for submacular hemorrhage secondary to PCV [14,15]. Studies have reported anatomical and functional improvements in both the as-needed regimen [14,16,17] as well as the fixed-dose regimen [15]. It is difficult to anticipate the complete cure of PCV; therefore, long-term treatment is usually required to preserve vision [18].…”

Section: Introductionmentioning

confidence: 99%

Long-Term Outcomes of Switching from Fixed-Dose to As-Needed Regimen for Treating Submacular Hemorrhage Secondary to Polypoidal Choroidal Vasculopathy

Kim¹,

Kim²,

Kim³

et al. 2020

JCM

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Background: The aim of this study was to evaluate outcomes in patients with submacular hemorrhage secondary to polypoidal choroidal vasculopathy (PCV) after switching treatment from a fixed-dose to an as-needed regimen. Methods: This retrospective study included 19 patients with submacular hemorrhage secondary to PCV who were treated with fixed-dose intravitreal aflibercept during the first 56 weeks. After 56 weeks, the treatment regimen was switched to an as-needed regimen. The incidence and timing of lesion reactivation during the as-needed phase were evaluated. The best-corrected visual acuity (BCVA) at baseline (beginning of the regimen) and the final follow-up were compared. Multivariate analysis was performed to determine the factors associated with lesion reactivation. Results: During the mean follow-up period of 27 ± 7.3 months, lesion reactivation was noted in 10 patients (52.6%; mean time period: 12.2 ± 9.1 months) in the as-needed phase. Reactivations were treated with anti-vascular endothelial growth factor (VEGF) injections (mean, 4.1 ± 2.6). The mean logarithm of the minimum angle of resolution (logMAR) BCVA was 0.26 ± 0.34 at baseline and 0.31 ± 0.38 at final follow-up (p = 0.212). Deterioration of ≥0.2 logMAR BCVA was noted in two patients (10.5%). In multivariate analysis, large lesion size was closely associated with a high risk of lesion reactivation (p = 0.009). Conclusion: Visual acuity was relatively stable after switching from a fixed-dose to an as-needed regimen, with no definite visual deterioration in the majority of patients. We conclude that patients with large lesions should be carefully monitored when switching to an as-needed regimen.

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Long‐term visual outcomes for treatment of submacular haemorrhage secondary to polypoidal choroidal vasculopathy

Abstract: IVB monotherapy appears to be as effective as combination therapies for treating SMH secondary to PCV with regards to BCVA at 24 months, and may be a cost-effective strategy for long-term management.

Cited by 8 publications

References 26 publications

Visual Outcomes and Prognostic Factors of Large Submacular Hemorrhages Secondary to Polypoidal Choroidal Vasculopathy

Visual Outcomes and Prognostic Factors of Large Submacular Hemorrhages Secondary to Polypoidal Choroidal Vasculopathy

The needle, or the knife?

Long-Term Outcomes of Switching from Fixed-Dose to As-Needed Regimen for Treating Submacular Hemorrhage Secondary to Polypoidal Choroidal Vasculopathy

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