Surgical Approach In Vitreous Hemorrhage

Abstract

Introduction: To report cases of retinal disorders that cause vitreous hemorrhage and the timing of pars plana vitrectomy in Cicendo Eye Hospital
 Methods: Retrospective observational study of all patients diagnosed with the vitreous hemorrhage who had undergone pars plana vitrectomy in 2016. Data were collected from medical record.
 Result: The mean age of this study is 54.65 years old from 260 vitreous hemorrhage patients. The most common retinal abnormalities are proliferative diabetic retinopathy (49.6%), wet age related macular degeneration (AMD) (13.5%), undetected retinal abnormalities (12.7%), retinal vein occlusion (8.8%), rhegmatogen retinal detachment (6.5%), trauma (3.45%), vasculitis (3.1%), idiopathic polypoidal choroidal vasculopathy (3.1%), and drop IOL (1.2%). PPV performed 1-3 months after initial assessment (31.25%), less than 1 month (13.2%), more than 3 months (14.6%)
 Conclusion: The most common etiology of vitreous hemorrhage is proliferative diabetic retinopathy. Pars plana vitrectomy was performed 1 – 3 months after an initial assessment of the patients.

Clinical Characteristics of Proliferative Diabetic Retinopathy (Pdr) Patients With Vitreous Hemorrhage at Cipto Mangunkusumo Hospital

“…This is similar to the study by Metita et al regarding vitreous hemorrhage with most patients being the result of PDR, it was stated that unilateral cases occurred in 89.6% of cases. 4 This study shows that most common systemic risk factors were hypertension and dyslipidemia. Bek T,et al, DM patients who are accompanied by increased pressure diastolic over 80, is more at risk for the progression of PDR, while an increase in systolic > 160 mm Hg, is at risk for Diabetic Macular Edema (DME).…”

“…Vitrectomy aims to overcome media turbidity and stabilize the proliferative process and increase retinal vascularization. 4,15,17 In this study the majority of treatments were vitrectomy performed in 142 eyes. All cases that underwent vitrectomy were grade 2 and 3 vitreous hemorrhage.…”

“…The final condition of the vitreous after vitrectomy treatment using silicone oil tamponade at the end of follow-up found that 99% of patients had clear vitreous. 4,17,18 This is due to good management of vitreous Anatomical assessment showed good results, as the condition of the vitreous that was clear after vitrectomy treatment, and there was no deterioration in treatment with anti-VEGF injections and PRP laser. Visual acuity before treatment compared to after treatment shows progress even though in some cases there was no improvement.…”

“…However, permanent decreased visual acuity can occur in some cases. 4 Diagnosis is based on anamnesis and physical examination of ophthalmological status.…”