Outcomes of Surgical Treatment in Cases with Submacular Hemorrhage

Özet

Purpose: The aim of this study was to evaluate the different surgical treatment techniques performed for patients with submacular hemorrhage (SMH) secondary to various etiologies in our clinic regarding anatomical and functional outcomes, and complications. Materials and Method: We retrospectively evaluated patients who presented to our retina department and underwent surgical treatment with diagnosis of SMH between 2014 and 2017. In all patients included, the SMH etiologies, measurements of SMH thickness and ar ea, duration and types of treatment modalities and complications were noted. Pre-and-postoperative best-corrected visual acuity (BC VA) and central macular thickness (CMT) values were also recorded. Results: Overall, 54 eyes of 53 patients were included. The mean age was 69.4±13.0 (13-93) years while mean follow-up duration was 5.8±10.5 (3-43) months. The most common etiology was neovascular age-related macular degeneration (55.6%); followed by polypoidal choroi dal vasculopathy (22.2%). It was noted that the mean BCVA was 2.0±0.8 (0.3-3) logMAR while the mean SMH thickness was 662.5±330.0 (197-1615) μm and the mean SMH area was 31.5±26.5 (2.8-145.3) mm2 at presentation. A significant improvement was found in mean BCVA (0.28 logMAR) at the final visit (p=0.041). No signi ficant relationship was found between BCVA improvement and SMH thickness or area at presentation (p>0.05)(r=-0.181). The mean time from symptom onset to SMH treatment was 13.7±16.3 (1-95) days. There was a negative correlation between the time from symptom onset to SMH treatment and BCVA improvement (p<0.001)(r=-0.548). There was a signi ficant difference between CMT values at baseline and those on months 1, 3, 6, 12 and at final visit (p<0.05). Conclusion: The different surgical approaches employed in cases with SMH due to various etiologies can provide significant improvement in visual prognosis. The time from symptom onset to SMH treatment is a significant predictor for the final visual acuity achieved by treatment.