Effectiveness of Vitrectomy for Polypoidal Choroidal Vasculopathy Associated with Vitreous Hemorrhage

  Objective  To evaluate the effectiveness of vitrectomy in treating polypoidal choroidal vasculopathy (PCV) associated with vitreous hemorrhage.

  Methods  We retrospectively analyzed the clinical data of 29 patients (18 males and 11 females, 29 eyes) who were first diagnosised as vitreous hemorrhage and ultimately confirmed to be with PCV after the standard pars plana vitrectomy (PPV) between July 2007 and August 2012 in our hospital. These patients aged 40 to 84 years (mean:61.5±11.5 years). The best corrected visual acuity (BCVA) was light perception in 5 eyes, hand moving in 17 eyes, counting finger in 3 eyes, < 0.1 in 3 eyes, and ≥ 0.1 in 1 eye. PPV were performed in all 29 eyes, among which 13 were given gas tamponade and 14 were given oil tamponade. Cataract extraction was performed for 14 eyes. The follow-up lasted 1 to 84 weeks (mean:33 weeks).

  Results  The BCVA was improved in 23 eyes (79.3%), and remained stable in 6 eyes (20.7%). At the end of the follow-up, the BCVA was ≥ 0.3 in 4 eyes, ≥ 0.1 in 6 eyes, ≥ 0.01 in 9 eyes, counting finger in 5 eyes, and hand moving in 5 eyes. The BCVA showed significant difference before and after the operation(t=6.032, P < 0.05). Retina remained attached in 28 eyes, including 8 eyes with silicone oil tamponade. Nevertheless, retina detachment was observed in one patient. All these 29 eyes had massive subretinal hemorrhage during the surgery, which was somehow absorbed after the surgery. In 7 patients, the blood was completely absorbed, leaving exudative membrane or pigment disorder.

  Conclusions  PPV is effective for the treatment of vitreous hemorrhage in PCV patient. When in combination with silicone oil or gas resules, it can achieve retinal reattachment and improve the vision in most patients.