Clinical Results of Vitrectomy in Macular Hemorrhage From a Ruptured Retinal Artery Macroaneurysm

ABSTRACT

PURPOSE: To evaluate the relationship between postoperative optical coherence tomography (OCT) findings and visual acuity in patients who underwent vitrectomy for macular hemorrhage related to the rupture of a retinal artery macroaneurysm. METHODS: A retrospective case review was conducted for patients who underwent vitrectomy for macular hemorrhage caused by a retinal arterial macroaneurysm. The relationship between postoperative OCT findings and visual acuity was analyzed. RESULTS: This study included 12 patients whose preoperative mean best corrected visual acuity (BCVA) (logMAR) was 1.7+/-0.8 and whose mean final BCVA was 0.6+/-0.5. These values were statistically different (p=0.004). Mean foveal thickness by OCT was 437.5+/-161.5 micrometer at the preoperative period and 252.8+/-84.9 micrometer three months postoperative, and this difference was statistically significant (p=0.017). As the foveal thickness decreased after removal of the remnant organized retinal hemorrhage in the postoperative period, BCVA improved at the final follow-up (p=0.048). According to the postoperative OCT, the photoreceptor disruption group presented a lower BCVA than that of the photoreceptor preservation group at the final follow-up (logMAR 1.4+/-0.4 vs. 0.3+/-0.2, p=0.009). CONCLUSIONS: Photoreceptor preservation as observed by OCT was significantly associated with better visual outcome after vitrectomy in patients with macular hemorrhage caused by rupture of a retinal arterial macroaneurysm.