| Predictive Factors for Submacular Hemorrhage in Age-related Macular Degeneration: A Retrospective Study |
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Hanwool Moon, Hyun Goo Kang, Junwon Lee, Christopher Seungkyu Lee, Min Kim, Suk Ho Byeon, Sung Soo Kim |
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Department of Ophthalmology, Institute of Vision Research, Severance Eye Hospital, Yonsei University College of Medicine, Seoul, Korea |
Correspondence:
Hyun Goo Kang, Tel: 82-2-2228-3570, Fax: 82-2-312-0541,
Email: hgkang08@yuhs.ac
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Received: 10 March 2024 • Revised: 30 July 2024 • Accepted: 26 September 2024 |
| Abstract |
Purpose
Little is known about the major risk factors for submacular hemorrhage (SMH). This study aimed to evaluate the factors associated with SMH in patients with neovascular age-related macular degeneration (nAMD) and polypoidal choroidal vasculopathy receiving three consecutive loading doses of intravitreal aflibercept or ranibizumab injections.
Methods
This retrospective cross-sectional study included 48 patients diagnosed with nAMD and polypoidal choroidal vasculopathy who completed three loading doses under a treat-and-extend regimen. Patients were divided into the SMH group and the non-SMH group (age- and sex-matched without SMH), with 24 patients in each group. Intravitreal injections, agents, and optical coherence tomography (OCT) features were compared.
Results
In the SMH group, SMH occurred approximately 3.29 years after post-nAMD diagnosis. The non-SMH group received more intravitreal injections of aflibercept and brolucizumab during the follow-up period after the initial loading phase. The SMH group exhibited a higher prevalence of serous/hemorrhagic pigment epithelial detachments (PEDs) at the last visit before SMH occurrence compared to the non-SMH group. Patients with a PED increase in the past two visits showed a higher tendency in the SMH group. No other OCT features significantly correlated with SMH development.
Conclusions
The presence of serous/hemorrhagic PEDs may indicate a higher risk of SMH, and eyes with these features should be closely monitored to prevent sudden and devastating visual loss caused by SMH. |
| Key Words:
Neovascular age-related macular degeneration, Pigment epithelial detachment, Polypoidal choroidal vasculopathy, Submacular hemorrhage |
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