Factors predictive of treatment outcomes in submacular hemorrhage secondary to age-related macular degeneration.

Purpose: To identify predictors for visual outcomes of eyes with submacular hemorrhage (SMH) secondary to neovascular age-related macular degeneration (nAMD).

Study design: Retrospective observational study.

Methods: Clinical data from patients diagnosed with SMH secondary to nAMD and treated with pneumatic displacement were collected. SMH thickness was measured by optical coherence tomography (OCT) at baseline and 1 week. Possible factors associated with best-corrected visual acuity (BCVA) gain at 3 months were analyzed.

Results: Fifty-six eyes of 56 patients (18 female/38 male; mean age, 77.8 ± 10.1 years) were analyzed; 34 were treatment-naïve and 22 were previously treated with anti-vascular endothelial growth factor agents. Multivariable analysis showed that greater BCVA gain more than 0.3 logMAR at 3 months post-treatment was associated with being treatment-naïve (odds ratio [OR], 34.30; 95% confidence interval [CI], 1.38-851.91; P = 0.031), thinner SMH thickness at 1 week after pneumatic displacement (OR, 0.38 per 50-unit increase; CI, 0.18-0.80; P = 0.011), and worse baseline BCVA (OR, 2.58 per 0.1-unit increase; CI, 1.31-5.07; P = 0.006), but not associated with age (OR, 0.50; 95% CI, 0.24-1.06), the time from onset to pneumatic displacement (OR, 1.04; 95%CI, 0.87-1.23), SMH thickness at baseline (OR, 0.92; 95%CI, 0.63-1.36), and the presence of subfoveal hemorrhagic PED (OR, 0.72; 95%CI, 0.08-6.84).

Conclusion: This study identifies novel factors predictive of visual outcomes for pneumatic displacement for SMH due to nAMD. The presence of residual SMH at 1 week following unsuccessful pneumatic displacement may warrant further intervention.