Visual Outcomes and Prognostic Factors of Large Submacular Hemorrhages Secondary to Polypoidal Choroidal Vasculopathy

Figures & data

Figure 1 A representative case of a large submacular hemorrhage (SMH) secondary to polypoidal choroidal vasculopathy. (A) A color fundus photograph shows a large SMH. (B and C) Infrared reflectance and optical coherence tomography (OCT) images show the SMH and hemorrhagic retinal pigment epithelial detachment. (B) The green arrow indicates the direction of OCT scan in (C). (D and E) Fluorescein and indocyanine green angiography performed after pneumatic displacement. (E) The yellow arrow indicates a polypoidal lesion. (F and G) Fluorescein angiography and OCT images performed after pneumatic displacement. (F) The green arrow indicates the direction of the OCT scan in (G). (G) The yellow arrow indicates the polypoidal lesion.

Table 1 Characteristics of Patients with Large SMHs Secondary to PCV

Characteristics
No. eyes	30
Age (years)	70.8 ± 11.5
No. women (%)	5 (17%)
Systemic hypertension - no. (%)	20 (67%)
Anticoagulant therapy - no. (%)	2 (7%)
Antiplatelet therapy - no. (%)	6 (20%)
Initial area of SMH
20 disc areas or larger - no. (%)	11 (37%)
Breakthrough vitreous hemorrhage - no. (%)	11 (37%)
Treatment for PCV before SMH - no. (%)	4 (13%)
Treatment after SMH
Pneumatic displacement - no. (%)	13 (43%)
Anti-VEGF therapy - no. (%)	22 (73%)
Pars plana vitrectomy - no. (%)	4 (13%)
nAMD in fellow eyes - no. (%)	9 (30%)

Abbreviations: nAMD, neovascular age-related macular degeneration; PCV, polypoidal choroidal vasculopathy; SMH, submacular hemorrhage; VEGF, vascular endothelial growth factor.

Figure 2 The best-corrected visual acuities (BCVAs) expressed in logarithm of the minimum angle of resolution (logMAR) units (mean ± standard deviation) at the development, 1 month, and 1 year after the development of large submacular hemorrhages, and at the final visit.

Table 2 Prognostic Factors Predictive of BCVA 1 Year After Development of Large SMHs Secondary to PCV

	Univariate Analyses			Multiple Regression Analyses
	Coefficient	95% CI	p value	Coefficient	95% CI	p value
Age	0.017	−0.00583–0.04035	0.137
Gender (female)	0.062	−0.67524–0.79924	0.865
Systemic hypertension	0.553	0.00999–1.09501	0.046	0.129	−0.14952–0.40701	0.349
Anticoagulant therapy	0.013	−1.08954–1.11454	0.982
Antiplatelet therapy	−0.298	−0.97542–0.37959	0.375
Initial area of SMH 20 disc areas or larger	1.022	0.61137–1.43313	<0.001	0.481	0.16266–0.80012	0.005
Breakthrough vitreous hemorrhage	0.650	0.13804–1.16196	0.015	−0.278	−0.61652–0.06099	0.103
Treatment for PCV before SMH	0.215	−0.58899–1.01976	0.588
Pneumatic displacement after SMH	−0.529	−1.04473–-0.01364	0.045	−0.243	−0.51919–0.03311	0.082
Anti-VEGF therapy after SMH	−0.953	−1.45363–−0.45319	<0.001	−0.213	−0.55068–0.12421	0.204
Pars plana vitrectomy after SMH	0.244	−0.55891–1.04737	0.538
nAMD in fellow eyes	0.183	−0.41233–0.779	0.534
BCVA 1 month after development	0.721	0.52401–0.91825	<0.001	0.564	0.34847–0.779	<0.001

Note: Figures in bold style represent p <0.05.

Abbreviations: BCVA, best-corrected visual acuity; CI, confidence interval; nAMD, neovascular age-related macular degeneration; PCV, polypoidal choroidal vasculopathy; SMH, submacular hemorrhage; VEGF, vascular endothelial growth factor.