Quantification of retinal changes after resolution of submacular hemorrhage secondary to polypoidal choroidal vasculopathy

Jpn J Ophthalmol. 2018 Jan;62(1):54-62. doi: 10.1007/s10384-017-0549-2. Epub 2017 Nov 29.

Abstract

Purpose: To evaluate changes in the thickness of retinal layers after resolution of submacular hemorrhage secondary to polypoidal choroidal vasculopathy (PCV).

Study design: Retrospective, observational study.

Methods: This study included 21 patients (21 eyes) who had been diagnosed with submacular hemorrhage secondary to PCV and treated using anti-vascular endothelial growth factor monotherapy. After the hemorrhage had resolved, the thicknesses of the retinal layers were measured on horizontal- and vertical-crosshair optical coherence tomography scan images. The thickness of each layer in the region affected by the hemorrhage was compared with the thickness of the layer in the corresponding region in the fellow eye, as well as between an unaffected region in the eye with the hemorrhage and the corresponding region in the fellow eye.

Results: Optical coherence tomography (OCT) was performed 5.5±2.8 months after diagnosis. In the horizontal OCT images, the outer plexiform layer (OPL) and outer nuclear layer (ONL) + photoreceptor layer (PRL) were significantly thinner in the affected region than in the corresponding region (P = 0.019 and P <0.001, respectively). In the vertical OCT image, the ONL+PRL was significantly thinner in the affected region than in the corresponding region (P <0.001). The thickness of the retinal layer in the unaffected region did not differ from that in the corresponding region of the fellow eye.

Conclusions: The significant thinning of the outer retinal layers in the regions affected by submacular hemorrhage suggests that the hemorrhage induces marked damage in the outer retinal layers, explaining the poor visual prognosis of submacular hemorrhage.

Keywords: Age-related macular degeneration; Hemorrhage; Outer nuclear layer; Photoreceptor layer; Polypoidal choroidal vasculopathy.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / therapeutic use
  • Choroidal Neovascularization / complications
  • Choroidal Neovascularization / drug therapy
  • Choroidal Neovascularization / physiopathology*
  • Coloring Agents / administration & dosage
  • Female
  • Fluorescein Angiography
  • Humans
  • Indocyanine Green / administration & dosage
  • Intravitreal Injections
  • Male
  • Middle Aged
  • Polyps / complications
  • Polyps / drug therapy
  • Polyps / physiopathology*
  • Ranibizumab / therapeutic use
  • Receptors, Vascular Endothelial Growth Factor / therapeutic use
  • Recombinant Fusion Proteins / therapeutic use
  • Retinal Hemorrhage / drug therapy
  • Retinal Hemorrhage / etiology
  • Retinal Hemorrhage / physiopathology*
  • Retinal Neurons / pathology*
  • Retrospective Studies
  • Tomography, Optical Coherence
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity

Substances

  • Angiogenesis Inhibitors
  • Coloring Agents
  • Recombinant Fusion Proteins
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • aflibercept
  • Receptors, Vascular Endothelial Growth Factor
  • Indocyanine Green
  • Ranibizumab