Etiological Analysis of Non Traumatic, Non Diabetic Spontaneous Vitreous Hemorrhage Using Vitrectomy

Kyu Kin Han; Young Hoon Lee; Young Suk Chang

doi:10.3341/jkos.2015.56.12.1887

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Han, Lee, and Chang: Etiological Analysis of Non Traumatic, Non Diabetic Spontaneous Vitreous Hemorrhage Using Vitrectomy

Original Article

J Korean Ophthalmol Soc 2015;56(12):1887-1892.

Published online: 29 August 2015

DOI: https://doi.org/10.3341/jkos.2015.56.12.1887

Etiological Analysis of Non Traumatic, Non Diabetic Spontaneous Vitreous Hemorrhage Using Vitrectomy

Kyu Kin Han, M.D, Young Hoon Lee, M.D, Young Suk Chang, M.D

Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Korea

Address reprint requests to Young Suk Chang, MD Department of Ophthalmology, Konyang University Hospital, #158 Gwanjeodong-ro, Seo-gu, Daejeon 35365, Korea Tel: 82-42-600-9258, Fax: 82-42-600-9251 E-mail: 98cys@hanmail.net

‗ This study was presented as a narration at the 113th Annual Meeting of the Korean Ophthalmological Society 2015.

Received 15 May 201513 July 2015 Accepted 22 October 2015

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

In this study we evaluated and analyzed the causes and prognosis of spontaneous vitreous hemorrhage except direct ocular trauma and diabetic retinopathy-induced vitreous hemorrhage confirmed after therapeutic vitrectomy.

Methods

The present study included Non-traumatic, non-diabetic vitreous hemorrhage patients who underwent vitrectomy in our hospital from March 2010 to December 2013 and were followed up for more than 1 year. Past history, preoperative visual acuity and intraocular pressure were evaluated postoperatively at 1, 3, 6 and 12 months.

Results

A total of 157 patients (157 eyes) were included in the study. Common causes of vitreous hemorrhage were branch reti-nal vein occlusion, retinal tear and age-related macular degeneration. Age-related macular degeneration and central retinal vein occlusion patients showed a poor visual prognosis. Lattice retinal degeneration or retinal tear in the opposite eye was observed in 27 patients and therefore, barrier laser was performed.

Conclusions

The most common cause of spontaneous vitreous hemorrhage was retinal vein occlusion. Visual prognosis varied depending on the cause of disease, but significant vision improvement can be expected if the macula is not involved. Additionally, in some patients without evidence of retinal detachment on ultrasound, a possible retinal tear accompanied by lo-calized retinal detachment should be considered.

Keywords: Spontaneous vitreous hemorrhage

References

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Figure 1.

B-scan image of vitreous hemorrhage without retinal detachment.

Table 1.

Demographic characteristics and clinical features of the patients

Variables	Data
Age (years)	63.9 ± 12.7
Range	9-89
Gender (male:female)	84:73
Previous medical history
Hypertension	93
Diabetus mellitus	36
Previous symptom duration (days)	39.6
Preoperative BCVA (log MAR)	1.83 ± 0.43
Preoperative IOP (mm Hg)	13.4 ± 4.23
Vitrectomy gauge (23 gauge:25 gauge)	95:62

Values are presented as mean ± SD unless otherwise indicated. SD = standard deviation; BCVA = best corrected visual acuity; IOP = intraocular pressure.

Table 2.

Cause of vitreous hemorrhage identified by vitrectomy

Age	Cause of vitreous hemorrhage
	Age	Retinal tear	BRVO	CRVO	AMD	Macroaneurysm	Eales	Terson	Angioma	Unknown
0-9	1
10-19
20-29	2	1
30-39	1	1
40-49	2	3	3	1	1
50-59	11	22	1	4	2
60-69	9	19	3	5	1	3
70-79	6	20	3	13	2	1	5
80-89	6	4	1
Total	30	70	10	26	5	2	1	1	12
BRVO = bra	nch retinal vein	occlusion; CR	RVO = centr	ral retinal vein	occlusion; AMD	= age-related	macular deg	eneration.

Table 3.

Prognostic factors associated with postoperative 12-months visual acuity

Variables	Preoperative BCVA	Postoperative 12 months BCVA
(log MAR)	(log MAR)
Macular state	0.043
Macular involve	1.79 ± 0.46	1.67 ± 0.47
Macular spare	1.59 ± 0.56	0.34 ± 0.52
Vitrectomy entry system	0.269
23 gauge	1.50 ± 0.61	0.58 ± 0.66
25 gauge	1.71 ± 0.45	0.66 ± 0.65
Vitreous cavity tamponade material	0.315
Air	1.53 ± 0.76	0.12 ± 0.18
C₃ F₈	1.45 ± 0.70	0.21 ± 0.17
SF₆	1.03 ± 0.61	0.20 ± 0.17

Values are presented as mean ± SD unless otherwise indicated. BCVA = best corrected visual acuity ^*Chi-square test.

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