One-year outcomes of pneumatic displacement for submacular hemorrhage secondary to neovascular age-related macular degeneration.

Abstract

Purpose: To investigate the one-year outcomes of pneumatic displacement for submacular hemorrhage (SMH) secondary to neovascular age-related macular degeneration (nAMD). We compared cases of polypoidal choroidal vasculopathy (PCV) and non-PCV.

Study design: A retrospective observational study.

Methods: We reviewed the medical records of 76 eyes of 74 patients with SMH secondary to nAMD who underwent pneumatic displacement as initial treatment. The primary outcomes were best-corrected visual acuity (BCVA), complications, and additional treatment.

Results: We examined 54 eyes with PCV and 22 eyes with non- PCV. Approximately 0.5 mL of 100% sulfur hexafluoride (SF₆) gas was injected into the vitreous cavity. After pneumatic displacement, 19 eyes (25%) underwent vitrectomy for complications such as vitreous hemorrhage or retinal detachment. Additionally, 95% of eyes that underwent vitrectomy had hemorrhage extending beyond the arcade vessels at baseline. During the 12 months, the average number of anti-vascular endothelial growth factor (VEGF) injections was 7.0±3.6 in PCV cases and 7.0±3.3 in non-PCV cases (P=0.74). The mean BCVA at 12 months improved from 0.77±0.44 to 0.42±0.45 in PCV cases (P<0.01) and from 1.13±0.51 to 0.88±0.59 in non-PCV cases (P=0.01). The PCV group had better BCVA than the non-PCV group at both time points (P<0.01). In the previously treated group, 100% of non-PCV cases had worsened visual acuity compared to pre-onset SMH, while 62% of PCV cases maintained pre-onset visual acuity (P<0.01).

Conclusion: Pneumatic displacement resulted in superior visual outcomes in the PCV group compared to the non-PCV group for submacular hemorrhage secondary to nAMD. .