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Study: Severe vitreous hemorrhage associated with worse visual outcomes in patients with primary rhegmatogenous retinal detachment

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Among patients with rhegmatogenous retinal detachment without prior vitreoretinal surgery, severe vitreous hemorrhage may be associated with a longer duration of preoperative hemorrhage, a higher incidence of severe proliferative vitreoretinopathy and worse visual outcomes, according to a multicenter study by researchers in Taiwan.

"Close follow-up and aggressive surgical interventions are suggested in these patients," the authors said.

To determine the relationship between the severity of vitreous hemorrhage and visual outcomes, Ling Yeung, MD, and colleagues retrospectively reviewed 71 eyes of 71 patients with rhegmatogenous retinal detachment and vitreous hemorrhage between January 1993 and December 2002. Specifically, 38 patients had mild to moderate vitreous hemorrhage, and 33 patients had severe vitreous hemorrhage. These patients averaged 48 years of age, ranging from 7 to 78 years.

Follow-up ranged from 12 to 140 months.

At final follow-up, the mean logMAR visual acuity of the 38 eyes in group one had improved from 1.90 (20/1589) to 0.68 (20/96), the authors noted.

Among the 33 eyes in group two, mean logMAR visual acuity had improved from 2.42 (20/5261) to 1.63 (20/853).

The investigators reported that patients with severe vitreous hemorrhage were significantly older (P = .002) and had a longer duration of preoperative hemorrhage (P = .004), a lower baseline visual acuity (P < .001), worse final visual acuity (P < .001) and a higher incidence of severe proliferative vitreoretinopathy (P = .002), according to the study.

"More eyes in group two required silicone oil tamponade, although this was not statistically significant," the authors noted.

In both groups, the overall recurrence rate of retinal detachment after primary surgery was approximately 21%, according to the study, published in the March issue of Acta Ophthalmologica.