Location of submacular hemorrhage as a predictor of visual outcome after intravitreal ranibizumab for age-related macular degeneration

Dimitrios Karagiannis,¹ Irini Chatziralli,¹ Konstantinos Kaprinis,¹ Ilias Georgalas,² Efstratios Parikakis,¹ Panagiotis Mitropoulos<sup>1

1</sup>Second Department of Ophthalmology, Ophthalmiatrion Athinon, Athens, Greece; ²First Department of Ophthalmology, University of Athens, Athens, Greece

Purpose: To evaluate the anatomical and functional outcomes in patients with submacular hemorrhage (SMH) due to age-related macular degeneration (AMD) treated with ranibizumab, and to evaluate the potential role of the SMH location in the final outcome after treatment.
Methods: Participants in this study were 12 treatment-naïve patients with SMH due to neovascular AMD who were treated with intravitreal ranibizumab and had at least 12 months’ follow-up. All patients underwent best-corrected visual acuity measurement and optical coherence tomography at baseline and at every visit posttreatment, while fluorescein angiography was done at baseline and at the discretion of the physician thereafter.
Results: Of the patients, 83.4% showed improvement or stabilization in best-corrected visual acuity after treatment at the 12-month follow-up, with a mean number of 7.3±2.9 injections. Patients with SMH surrounding the foveal area in 360° presented worse anatomical and functional outcomes compared to those with SMH adjacent to the fovea.
Conclusion: Intravitreal ranibizumab seems to be safe and effective, either improving or stabilizing visual acuity, in patients with SMH due to wet AMD. The location of the SMH may predict the final outcome after treatment.

Keywords: age-related macular degeneration, ranibizumab, submacular hemorrhage, treatment