title: Visual outcomes of vitrectomy for polypoidal choroidal vasculopathy-related breakthrough vitreous haemorrhage.
abstract: OBJECTIVE
  To evaluate the long-term visual outcomes of pars plana vitrectomy (PPV) for polypoidal choroidal vasculopathy (PCV)-associated vitreous haemorrhage (VH).
  
  
  METHODS
  We retrospectively reviewed the records of patients with PCV-related VH who underwent PPV. The main outcome measures were best-corrected visual acuity (BCVA) and fundus findings at 3 months postoperatively and final visit.
  
  
  RESULTS
  Seventeen eyes of 17 patients with massive subretinal haemorrhage (16.7±7.1 disc size of mean subretinal haemorrhage area) were enrolled. The mean postoperative follow-up period was 25.2 months. Four eyes received intravitreal bevacizumab injections, and three eyes underwent photodynamic therapy before the onset of VH. The mean BCVA improved from logarithm of the minimum angle of resolution (LogMAR) of 2.63±0.57 preoperatively to 1.43±0.82 at final visit (P<0.001). Among the eyes with initial polyps at subfoveal or juxtafoveal area, 16.70% achieved final BCVA ≥20/400 (LogMAR 1.3), whereas 87.50% of eyes with initial polyps at extrafoveal area had final BCVA ≥20/400 (Fisher's exact test, P=0.026).
  
  
  CONCLUSIONS
  PCV with massive subretinal haemorrhage is at risk for breakthrough VH. The visual prognosis in eyes with PCV-related breakthrough VH is variable after vitrectomy. Initial polyps at the extrafoveal area led to better functional outcomes. Early vitrectomy may be beneficial for visual recovery after PCV-related VH.
authors.affiliation: Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: H-C
authors.initials: HC
authors.lastname: Lin
authors.affiliation: Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: C-H
authors.initials: CH
authors.lastname: Yang
authors.affiliation: Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: C-M
authors.initials: CM
authors.lastname: Yang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use; D000068258:Bevacizumab; D020256:Choroidal Neovascularization / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D010778:Photochemotherapy; D011127:Polyps / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D014463:Ultrasonography; D014792:Visual Acuity / Q000502:physiology*; D014821:Vitrectomy / Q000379:methods*; D014823:Vitreous Hemorrhage / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab