Surgical treatment of submacular hemorrhage associated with idiopathic polypoidal choroidal vasculopathy.
OBJECTIVE
To report the visual outcome of surgical treatment of submacular hemorrhage associated with idiopathic polypoidal choroidal vasculopathy.


METHODS
Eight eyes of eight consecutive patients with thick submacular hemorrhages associated with idiopathic polypoidal choroidal vasculopathy were treated with pars plana vitrectomy and tissue plasminogen activator-assisted removal of subretinal blood (December 1995 to September 1997) or intravitreal 100% sulfur hexafluoride gas injection without tissue plasminogen activator (October 1997 to March 1998).


RESULTS
Postoperatively, laser treatment was performed for active polypoidal lesions outside the foveal avascular zone in four eyes. A retinal pigment epithelial tear was seen outside the foveal avascular zone in three eyes, and one eye developed a retinal detachment. The best-corrected visual acuity improved (by 3 or more lines) or stabilized in seven of the eight eyes. Four eyes had a final best-corrected visual acuity of 20/40 or better, and three eyes had a final best-corrected visual acuity of 20/50 to 20/200. In one eye, the visual acuity decreased from 20/100 to 20/500 because of the development of a subfoveal neovascular membrane. The membrane was excised, and histologic examination showed fibrovascular tissue between the retina and retinal pigment epithelium (type 2 pattern).


CONCLUSIONS
Surgical intervention may be of benefit in eyes with submacular hemorrhage associated with idiopathic polypoidal choroidal vasculopathy.
Shiraga
F
F
Department of Ophthalmology, Okayama University Medical School, Japan. fumio327@msn.com
Matsuo
T
T
Yokoe
S
S
Takasu
I
I
Okanouchi
T
T
Ohtsuki
H
H
Grossniklaus
H E
HE
D000368:Aged; D002829:Choroid / Q000098:blood supply* / Q000473:pathology; D015862:Choroid Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D007267:Injections; D017075:Laser Coagulation; D008266:Macula Lutea / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis / Q000601:surgery; D012086:Reoperation; D012160:Retina; D012166:Retinal Hemorrhage / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D013459:Sulfur Hexafluoride / Q000627:therapeutic use; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use; D014821:Vitrectomy; D014822:Vitreous Body
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator; D013459:Sulfur Hexafluoride