Clinical Ophthalmology (Mar 2021)
Long-Term Favorable Visual Outcomes in Patients with Large Submacular Hemorrhage
Abstract
Prashanth G Iyer,1 H Logan Brooks Jr,2 Harry W Flynn Jr1 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA; 2Southern Vitreoretinal Associates, Tallahassee, FL, USACorrespondence: Harry W Flynn JrSouthern Vitreoretinal Associates, 900 NW 17th Street, Miami, FL, 33136, USATel +1 305 326-6148Fax +1 305 326-6417Email [email protected]: Submacular hemorrhage (SMH) has been reported to be toxic to the retina based on animal studies. However, observational studies of patients with neovascular-related SMH and those treated with intravitreal anti-vascular growth factor (anti-VEGF) therapy have shown many favorable visual acuity outcomes. We report two cases of neovascular-related SMH with ten or more years of follow-up. The first case was an 83-year old female with a history of nonexudative age-related macular degeneration in both eyes presenting with sudden decrease in vision (20/400) in her right eye due to a large SMH, treated with anti-VEGF therapy. Over the next following months, there was resolution of the hemorrhage and return of good visual acuity. At 10-year follow-up, visual acuity was 20/30 in the right eye. The second case was a 49-year old female with a history of presumed ocular histoplasmosis syndrome (POHS), presenting with sudden vision loss (20/400) in her right eye due to large, thick SMH. With observation and intermittent anti-VEGF therapy, there was resolution of the hemorrhage. At 30-year follow-up, visual acuity was 20/20 in the right eye.Keywords: choroidal neovascularization, submacular hemorrhage, anti-VEGF, retinal toxicity, age-related macular degeneration, presumed ocular histoplasmosis syndrome
