Vitrectomy for exudative age-related macular degeneration with vitreous hemorrhage.
OBJECTIVE
The purpose of this study was to study the effect of pars plana vitrectomy (PPV) for age-related macular degeneration with vitreous hemorrhage on choroidal neo-vascularization (CNV).


METHODS
A retrospective interventional case series in which 92 eyes with age-related macular degeneration with vitreous hemorrhage that received PPV were studied. Among them, 60 eyes without pre- or posttreatment other than PPV were selected. Choroidal neovascularization was expressed as the incidence of bleeding 6 months before and after PPV. The status of CNV after PPV was compared and classified as worsened, remained, regressed, disappeared, or unclassified. The influence of posterior vitreous detachment was examined.


RESULTS
The incidence of bleeding was reduced dramatically after PPV (1.11 +/- 0.44 in preoperative 6 months vs. 0.03 +/- 0.18 in postoperative 6 months, P < 0.0001). The status of CNV improved in most cases; 40 of 54 classifiable eyes (74.1%) were categorized as "regressed" or "disappeared." Postoperative visual acuity was significantly better than preoperative visual acuity (P < 0.0001). The status of CNV subsided more in those eyes without posterior vitreous detachment than in those with posterior vitreous detachment (odds ratio, 1.02; 95% confidence interval, -0.01-2.08; P = 0.054).


CONCLUSIONS
The activity of CNV was reduced after PPV in eyes with age-related macular degeneration with vitreous hemorrhage. Visual acuity significantly improved, with only rare severe complications. The involvement of vitreomacular traction in the patho-physiology of CNV in age-related macular degeneration is possible.
Sakamoto
Taiji
T
Department of Ophthalmology, Kagoshima University School of Dental and Medical Sciences, Kagoshima, Japan. tsakamot@m3.kufm.kagoshima-u.ac.jp
Sheu
Shwu-Jiuan
SJ
Arimura
Noboru
N
Sameshima
Seiji
S
Shimura
Masahiko
M
Uemura
Akinori
A
Kawano
Hiroki
H
Wu
Tsung-Tien
TT
Kubota
Toshiaki
T
Sohma
Rika
R
Noda
Yoshihiro
Y
D000368:Aged; D000369:Aged, 80 and over; D002387:Cataract Extraction; D020256:Choroidal Neovascularization / Q000503:physiopathology*; D005122:Exudates and Transudates; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D008268:Macular Degeneration / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D020255:Vitreous Detachment / Q000503:physiopathology; D014823:Vitreous Hemorrhage / Q000209:etiology / Q000601:surgery*