OPTICAL COHERENCE TOMOGRAPHY FINDINGS AND SURGICAL OUTCOMES OF TISSUE PLASMINOGEN ACTIVATOR-ASSISTED VITRECTOMY FOR SUBMACULAR HEMORRHAGE SECONDARY TO AGE-RELATED MACULAR DEGENERATION.

Abstract

To study the relationship between morphologic findings using spectral domain optical coherence tomography and surgical outcomes in patients with submacular hemorrhage (SMH) secondary to age-related macular degeneration. Medical charts of nine eyes of nine patients who underwent tissue plasminogen activator-assisted vitrectomy for SMH secondary to age-related macular degeneration were retrospectively reviewed. The preoperative height and lateral width of both SMH and pigment epithelial detachment documented with optical coherence tomography, were measured. The status of ellipsoid layers was also analyzed. Complete displacement of SMH from the fovea was achieved in all nine eyes. The preoperative status of the ellipsoid layer under the fovea was detectable in four eyes and absent in the remaining five eyes. Postoperative best-corrected visual acuity was significantly better in eyes with preoperative detectable ellipsoid layers (P < 0.01). Eyes with preoperative SMH heights <400 μm also exhibited better best-corrected visual acuity (P < 0.05). There was no significant correlation between postoperative best-corrected visual acuity and the specific features of pigment epithelial detachment, including height, lateral width, and number. The preoperative presence of detectable ellipsoid layers and a lower height of SMH may predict good visual prognosis. In contrast, no specific features of pigment epithelial detachment correlated with postoperative best-corrected visual acuity.