PLoS ONE (Jan 2022)

Differences in clinical characteristics and treatment outcomes of submacular hemorrhage caused by age-related macular degeneration and retinal macroaneurysms: A multicenter survey from the Japan Clinical Retina Study (J-CREST) group.

  • Takeshi Kimura,
  • Takashi Araki,
  • Tsutomu Yasukawa,
  • Aki Kato,
  • Soichiro Kuwayama,
  • Takamasa Kinoshita,
  • Fumiki Okamoto,
  • Tomoya Murakami,
  • Yoshinori Mitamura,
  • Taiji Sakamoto,
  • Hiroto Terasaki,
  • Sentaro Kusuhara,
  • Akiko Miki,
  • Yoshihiro Takamura,
  • Mineo Kondo,
  • Hisashi Matsubara,
  • Tetsuo Ueda,
  • Hiroki Tsujinaka,
  • Fumi Gomi

DOI
https://doi.org/10.1371/journal.pone.0274508
Journal volume & issue
Vol. 17, no. 9
p. e0274508

Abstract

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PurposeTo evaluate the clinical characteristics, treatment trends, and visual prognosis of submacular hemorrhage (SMH) secondary to neovascular age-related macular degeneration (nAMD) and retinal arterial macroaneurysm (RAM).MethodsThis retrospective study enrolled 187 Japanese patients with SMH at 10 institutions from 2015 to 2018. Medical records including SMH etiology, best-corrected visual acuity (BCVA), fundus photographs, optical coherence tomography images, and selected treatments were analyzed.ResultsMajor causes of SMH were typical nAMD (tnAMD) (18%), polypoidal choroidal vasculopathy (PCV) (50%) and RAM (29%). Age, male/female ratio, baseline BCVA, central retinal thickness, and involved retinal layers were significantly different between etiologies (all PConclusionsThe characteristics of, and treatment strategy for, SMH were different between the underlying diseases. Anti-vascular endothelial growth factor treatment with or without expansile gas was mainly chosen for SMH in tnAMD and PCV, whereas vitrectomy with gas was the most common treatment for RAM, and the higher rate for vitrectomy might result in the greater BCVA improvement in the RAM group than in the other groups. Final BCVA was better in PCV, RAM, and tnAMD, in that order, because patients with PCV were younger and had better baseline BCVA.