Association between severity of vitreous haemorrhage and visual outcome in primary rhegmatogenous retinal detachment.
OBJECTIVE
To elucidate the relationship between the severity of vitreous haemorrhage (VH) and visual outcome in primary rhegmatogenous retinal detachment (RRD) without previous vitreoretinal surgery.


METHODS
We carried out a retrospective review of patients presenting with RRD and VH between January 1993 and December 2002. Diabetic retinopathy, retinal vessel occlusion and open-globe injury patients were excluded. Study patients were separated into group 1 (eyes with mild to moderate VH) and group 2 (eyes with severe VH).


RESULTS
Our sample included 71 eyes of 71 patients (mean age 48.0 years, range 7-78 years) (median follow-up period 19 months, range 12-140 months), of which 21 had mild, 17 had moderate and 33 had severe VH. The mean visual acuity (VA) in logMAR (logarithm of minimum angle of resolution) of the 38 eyes in group 1 improved from 1.90 (Snellen equivalent [SE] 20/1589) to 0.68 (SE 20/96). In the 33 eyes in group 2, mean logMAR VA improved from 2.42 (SE 20/5261) to 1.63 (SE 20/853). Group 2 patients were significantly older (p = 0.002), had longer duration of preoperative haemorrhage (p = 0.004), lower presenting VA (p < 0.001), worse final VA (p < 0.001), and a higher incidence of severe (grade C) proliferative vitreoretinopathy (PVR) (p = 0.002). More eyes in group 2 required silicone oil tamponade, although this was not statistically significant (p = 0.133). The overall recurrence rate of retinal detachment after primary surgery was around 21% in both groups.


CONCLUSIONS
Rhegmatogenous retinal detachment with severe VH is associated with longer duration of preoperative haemorrhage, a higher incidence of severe PVR and worse visual outcome. Close follow-up and aggressive surgical interventions are suggested in these patients.
Yeung
Ling
L
Department of Ophthalmology, Chang Gung Memorial Hospital, Keelung, Taiwan.
Yang
Ko-Jen
KJ
Chen
Tun-Lu
TL
Wang
Nan-Kai
NK
Chen
Yen-Po
YP
Ku
Wan-Chen
WC
Lai
Chi-Chun
CC
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012163:Retinal Detachment / Q000150:complications* / Q000209:etiology / Q000601:surgery*; D012167:Retinal Perforations / Q000150:complications*; D012189:Retrospective Studies; D012591:Scleral Buckling; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy; D018630:Vitreoretinopathy, Proliferative / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D014823:Vitreous Hemorrhage / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery*