title: Variations in the clinical course of submacular hemorrhage.
abstract: OBJECTIVE
  To assess variations in the clinical course of submacular hemorrhages.
  
  
  METHODS
  We reviewed fundus photography charts taken of patients during a 27-month period. Thirty-one eyes of 31 patients with submacular hemorrhages under the foveal avascular zone were reviewed.
  
  
  RESULTS
  In 20 of the eyes, the underlying etiology was age-related macular degeneration (ARMD). The other 11 eyes had various underlying conditions, including macroaneurysms (two), presumed ocular histoplasmosis syndrome (two), trauma (one), Valsalva's retinopathy (one), idiopathic central serous choroidopathy (one), diabetic retinopathy (two), central retinal vein occlusion (one), and choroidal rupture (one). Of the eyes with ARMD (mean follow-up, 29 months), eight (40%) of 20 showed an improvement in visual acuity (> or = 2 Snellen lines), six (30%) of 20 had a final visual acuity of 20/80 or better, and three (15%) had a final visual acuity of 20/40 or better (range, 20/25 to 20/80). Of the eyes without ARMD (mean follow-up, 29 months), five (45) of 11 had an improvement in visual acuity and five (45%) of 11 attained a final visual acuity of 20/40 or better (range, 20/20 to 20/40). The best predictive factor for poor final visual acuity was the presence of a subretinal neovascular membrane.
  
  
  CONCLUSIONS
  Patients with submacular hemorrhage may have spontaneous improvement in visual acuity without surgery. Patients without subretinal neovascular membranes had a better visual improvement rate.
authors.affiliation: Department of Ophthalmology, University of Puerto Rico School of Medicine, Río Piedras, Puerto Rico.
authors.forename: M H
authors.initials: MH
authors.lastname: Berrocal
authors.forename: M L
authors.initials: ML
authors.lastname: Lewis
authors.forename: H W
authors.initials: HW
authors.lastname: Flynn
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015862:Choroid Diseases / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D008266:Macula Lutea / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010781:Photography; D012164:Retinal Diseases / Q000150:complications; D012166:Retinal Hemorrhage / Q000209:etiology / Q000503:physiopathology*; D012189:Retrospective Studies; D014792:Visual Acuity / Q000502:physiology