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DISEASE ACTIVITY AFTER DEVELOPMENT OF LARGE SUBRETINAL HEMORRHAGE IN POLYPOIDAL CHOROIDAL VASCULOPATHY

Baek, Jiwon, MD, PhD*; Kim, Jae Hui, MD; Lee, Mee Yon, MD, PhD; Lee, Won Ki, MD, PhD§

doi: 10.1097/IAE.0000000000001817
Original Study: PDF Only

Purpose: To investigate changes in disease activity after a large subretinal hemorrhage in polypoidal choroidal vasculopathy.

Methods: Fifty-two polypoidal choroidal vasculopathy eyes with large subretinal hemorrhage (at initial presentation [n = 33, Group 1] or developed during follow-up [n = 19, Group 2]) were enrolled. Thirty polypoidal choroidal vasculopathy eyes without subretinal hemorrhage were enrolled as controls. All subretinal hemorrhages were treated with pneumatic displacement. Other active lesions were treated with intravitreal ranibizumab on an as-needed basis. Injection-free period, 1-year injection numbers, and polyp presence on indocyanine green angiography were analyzed.

Results: The injection frequency significantly diminished after hemorrhage (1.2 ± 1.8 in Group 1 and 1.1 ± 2.1 in Group 2) compared with control eyes (3.9 ± 3.0) in both groups (both P < 0.001) and the prehemorrhage period (4.7 ± 1.4) in Group 2 (P < 0.001). The median injection-free period after hemorrhage was 12.0 months in both groups. At least one polypoidal lesion disappeared after hemorrhage in 7 of 10 eyes (70%) with comparable indocyanine green angiography.

Conclusion: The activity of a polypoidal choroidal vasculopathy lesion diminished after a large subretinal hemorrhage, which was associated with rupture of major polyps.

Large subretinal hemorrhage is common in eyes with PCV. We assessed the disease conditions of PCV eyes after large subretinal hemorrhage and found that the disease activity diminished after hemorrhage, and the overall visual outcome was favorable. Therefore, careful follow-up and treatment after initial management of the hemorrhage is required.

*Department of Ophthalmology and Visual Science, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea;

Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea;

Department of Ophthalmology and Visual Science, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea; and

§Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Reprint requests: Won Ki Lee, MD, PhD, Department of Ophthalmology and Visual Science, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, #222 Banpodae-ro, Seocho-gu, Seoul, 06591, Korea; e-mail: wklee@catholic.ac.kr

None of the authors has any conflicting interests to disclose.

Conceived and designed the study: W. K. Lee and J. Baek. Collection and management of data: J. Baek, J. H. Kim, M. Y. Lee, and W. K. Lee. Analysis and interpretation of the data: W. K. Lee, J. Baek, and J. H. Kim. Preparation of the manuscript: W. K. Lee and J. Baek. Review or approval of the manuscript: All authors.

W. K. Lee has served on advisory boards for Novartis, Bayer, Allergan, Alcon, and Santen and has received consultancy fees from these companies. He has received payments for lectures from Novartis, Bayer, Allergan, and Alcon. J. Baek, J. H. Kim, and M. Y. Lee have no financial disclosure to report.

© 2018 by Ophthalmic Communications Society, Inc.