Long-term visual outcomes for treatment of submacular haemorrhage secondary to polypoidal choroidal vasculopathy

Hyun Goo Kang; Hyunseung Kang; Suk Ho Byeon; Sung Soo Kim; Hyoung Jun Koh; Sung Chul Lee; Min Kim

doi:10.1111/ceo.13198

Long-term visual outcomes for treatment of submacular haemorrhage secondary to polypoidal choroidal vasculopathy

Hyun Goo Kang, Hyunseung Kang, Suk Ho Byeon, Sung Soo Kim, Hyoung Jun Koh, Sung Chul Lee, Min Kim

Department of Ophthalmology

Research output: Contribution to journal › Article › peer-review

8 Citations (Scopus)

Abstract

Importance: There is no consensus on the optimal management of submacular haemorrhage (SMH) secondary to polypoidal choroidal vasculopathy (PCV). Background: To compare the long-term outcome of three treatment strategies for PCV with SMH. Design: Retrospective case series at two tertiary hospitals. Samples: A total of 48 consecutive eyes treated between July 2006 and March 2016. Methods: Patients were grouped according to the treatment received: 22 eyes with intravitreal bevacizumab (IVB), 14 with a combination of IVB and pneumatic displacement (PD) and 12 with IVB and vitrectomy (TPPV). Main Outcome Measures: Change in best-corrected visual acuity (BCVA) at onset and up to 24 months. Secondary measures included demographic data, imaging data and complications. Results: Comparing the mean BCVAs of the groups revealed significant differences only at month 1 (P = 0.005). Changes in the mean BCVA over time revealed no significance in the resulting final BCVA (P = 0.062), which was 20 out of 155 (logMAR 0.89 ± 0.64) for IVB monotherapy, 20 out of 174 (0.94 ± 1.04) for combined IVB + PD, and 20 out of 195 (0.99 ± 0.90) for combined IVB + TPPV eyes. Sustained long-term improvement of over three Snellen lines was found in seven (31.82%) IVB monotherapy, 10 (71.43%) combined IVB + PD, and seven (58.33%) combined IVB + TPPV eyes (P = 0.043). SMH recurrence was observed in two eyes after IVB monotherapy and one eye after combined IVB + PD (P = 0.786). Conclusions and Relevance: IVB monotherapy appears to be as effective as combination therapies for treating SMH secondary to PCV with regards to BCVA at 24 months, and may be a cost-effective strategy for long-term management.

Original language	English
Pages (from-to)	916-925
Number of pages	10
Journal	Clinical and Experimental Ophthalmology
Volume	46
Issue number	8
DOIs	https://doi.org/10.1111/ceo.13198
Publication status	Published - 2018 Nov

Bibliographical note

Funding Information:
sources: This study was supported by a faculty research grant of Yonsei University College of Medicine (6-2017-0149).The authors wish to acknowledge the essential contributions made by the team of statisticians (H.S.L and S.N.K) from the Yonsei Biomedical Research Institute who helped conduct the analyses in this study.

Funding Information:
Funding sources: This study was supported by a faculty research grant of Yonsei University College of Medicine (6-2017-0149).

Publisher Copyright:
© 2018 Royal Australian and New Zealand College of Ophthalmologists

All Science Journal Classification (ASJC) codes

Ophthalmology

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10.1111/ceo.13198

Cite this

@article{7361f3d7afc345da8eedf5a08a37faee,

title = "Long-term visual outcomes for treatment of submacular haemorrhage secondary to polypoidal choroidal vasculopathy",

abstract = "Importance: There is no consensus on the optimal management of submacular haemorrhage (SMH) secondary to polypoidal choroidal vasculopathy (PCV). Background: To compare the long-term outcome of three treatment strategies for PCV with SMH. Design: Retrospective case series at two tertiary hospitals. Samples: A total of 48 consecutive eyes treated between July 2006 and March 2016. Methods: Patients were grouped according to the treatment received: 22 eyes with intravitreal bevacizumab (IVB), 14 with a combination of IVB and pneumatic displacement (PD) and 12 with IVB and vitrectomy (TPPV). Main Outcome Measures: Change in best-corrected visual acuity (BCVA) at onset and up to 24 months. Secondary measures included demographic data, imaging data and complications. Results: Comparing the mean BCVAs of the groups revealed significant differences only at month 1 (P = 0.005). Changes in the mean BCVA over time revealed no significance in the resulting final BCVA (P = 0.062), which was 20 out of 155 (logMAR 0.89 ± 0.64) for IVB monotherapy, 20 out of 174 (0.94 ± 1.04) for combined IVB + PD, and 20 out of 195 (0.99 ± 0.90) for combined IVB + TPPV eyes. Sustained long-term improvement of over three Snellen lines was found in seven (31.82%) IVB monotherapy, 10 (71.43%) combined IVB + PD, and seven (58.33%) combined IVB + TPPV eyes (P = 0.043). SMH recurrence was observed in two eyes after IVB monotherapy and one eye after combined IVB + PD (P = 0.786). Conclusions and Relevance: IVB monotherapy appears to be as effective as combination therapies for treating SMH secondary to PCV with regards to BCVA at 24 months, and may be a cost-effective strategy for long-term management.",

author = "Kang, {Hyun Goo} and Hyunseung Kang and Byeon, {Suk Ho} and Kim, {Sung Soo} and Koh, {Hyoung Jun} and Lee, {Sung Chul} and Min Kim",

note = "Funding Information: sources: This study was supported by a faculty research grant of Yonsei University College of Medicine (6-2017-0149).The authors wish to acknowledge the essential contributions made by the team of statisticians (H.S.L and S.N.K) from the Yonsei Biomedical Research Institute who helped conduct the analyses in this study. Funding Information: Funding sources: This study was supported by a faculty research grant of Yonsei University College of Medicine (6-2017-0149). Publisher Copyright: {\textcopyright} 2018 Royal Australian and New Zealand College of Ophthalmologists",

year = "2018",

month = nov,

doi = "10.1111/ceo.13198",

language = "English",

volume = "46",

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T1 - Long-term visual outcomes for treatment of submacular haemorrhage secondary to polypoidal choroidal vasculopathy

AU - Kang, Hyun Goo

AU - Kang, Hyunseung

AU - Byeon, Suk Ho

AU - Kim, Sung Soo

AU - Koh, Hyoung Jun

AU - Lee, Sung Chul

AU - Kim, Min

N1 - Funding Information: sources: This study was supported by a faculty research grant of Yonsei University College of Medicine (6-2017-0149).The authors wish to acknowledge the essential contributions made by the team of statisticians (H.S.L and S.N.K) from the Yonsei Biomedical Research Institute who helped conduct the analyses in this study. Funding Information: Funding sources: This study was supported by a faculty research grant of Yonsei University College of Medicine (6-2017-0149). Publisher Copyright: © 2018 Royal Australian and New Zealand College of Ophthalmologists

PY - 2018/11

Y1 - 2018/11

N2 - Importance: There is no consensus on the optimal management of submacular haemorrhage (SMH) secondary to polypoidal choroidal vasculopathy (PCV). Background: To compare the long-term outcome of three treatment strategies for PCV with SMH. Design: Retrospective case series at two tertiary hospitals. Samples: A total of 48 consecutive eyes treated between July 2006 and March 2016. Methods: Patients were grouped according to the treatment received: 22 eyes with intravitreal bevacizumab (IVB), 14 with a combination of IVB and pneumatic displacement (PD) and 12 with IVB and vitrectomy (TPPV). Main Outcome Measures: Change in best-corrected visual acuity (BCVA) at onset and up to 24 months. Secondary measures included demographic data, imaging data and complications. Results: Comparing the mean BCVAs of the groups revealed significant differences only at month 1 (P = 0.005). Changes in the mean BCVA over time revealed no significance in the resulting final BCVA (P = 0.062), which was 20 out of 155 (logMAR 0.89 ± 0.64) for IVB monotherapy, 20 out of 174 (0.94 ± 1.04) for combined IVB + PD, and 20 out of 195 (0.99 ± 0.90) for combined IVB + TPPV eyes. Sustained long-term improvement of over three Snellen lines was found in seven (31.82%) IVB monotherapy, 10 (71.43%) combined IVB + PD, and seven (58.33%) combined IVB + TPPV eyes (P = 0.043). SMH recurrence was observed in two eyes after IVB monotherapy and one eye after combined IVB + PD (P = 0.786). Conclusions and Relevance: IVB monotherapy appears to be as effective as combination therapies for treating SMH secondary to PCV with regards to BCVA at 24 months, and may be a cost-effective strategy for long-term management.

AB - Importance: There is no consensus on the optimal management of submacular haemorrhage (SMH) secondary to polypoidal choroidal vasculopathy (PCV). Background: To compare the long-term outcome of three treatment strategies for PCV with SMH. Design: Retrospective case series at two tertiary hospitals. Samples: A total of 48 consecutive eyes treated between July 2006 and March 2016. Methods: Patients were grouped according to the treatment received: 22 eyes with intravitreal bevacizumab (IVB), 14 with a combination of IVB and pneumatic displacement (PD) and 12 with IVB and vitrectomy (TPPV). Main Outcome Measures: Change in best-corrected visual acuity (BCVA) at onset and up to 24 months. Secondary measures included demographic data, imaging data and complications. Results: Comparing the mean BCVAs of the groups revealed significant differences only at month 1 (P = 0.005). Changes in the mean BCVA over time revealed no significance in the resulting final BCVA (P = 0.062), which was 20 out of 155 (logMAR 0.89 ± 0.64) for IVB monotherapy, 20 out of 174 (0.94 ± 1.04) for combined IVB + PD, and 20 out of 195 (0.99 ± 0.90) for combined IVB + TPPV eyes. Sustained long-term improvement of over three Snellen lines was found in seven (31.82%) IVB monotherapy, 10 (71.43%) combined IVB + PD, and seven (58.33%) combined IVB + TPPV eyes (P = 0.043). SMH recurrence was observed in two eyes after IVB monotherapy and one eye after combined IVB + PD (P = 0.786). Conclusions and Relevance: IVB monotherapy appears to be as effective as combination therapies for treating SMH secondary to PCV with regards to BCVA at 24 months, and may be a cost-effective strategy for long-term management.

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Long-term visual outcomes for treatment of submacular haemorrhage secondary to polypoidal choroidal vasculopathy

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