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Long-Term Favorable Visual Outcomes in Patients with Large Submacular Hemorrhage

Authors Iyer PG, Brooks HL Jr, Flynn HW Jr

Received 21 January 2021

Accepted for publication 19 February 2021

Published 18 March 2021 Volume 2021:15 Pages 1189—1192

DOI https://doi.org/10.2147/OPTH.S300662

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 5

Editor who approved publication: Dr Scott Fraser


Prashanth G Iyer,1 H Logan Brooks Jr,2 Harry W Flynn Jr1

1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA; 2Southern Vitreoretinal Associates, Tallahassee, FL, USA

Correspondence: Harry W Flynn Jr
Southern Vitreoretinal Associates, 900 NW 17th Street, Miami, FL, 33136, USA
Tel +1 305 326-6148
Fax +1 305 326-6417
Email [email protected]

Abstract: Submacular hemorrhage (SMH) has been reported to be toxic to the retina based on animal studies. However, observational studies of patients with neovascular-related SMH and those treated with intravitreal anti-vascular growth factor (anti-VEGF) therapy have shown many favorable visual acuity outcomes. We report two cases of neovascular-related SMH with ten or more years of follow-up. The first case was an 83-year old female with a history of nonexudative age-related macular degeneration in both eyes presenting with sudden decrease in vision (20/400) in her right eye due to a large SMH, treated with anti-VEGF therapy. Over the next following months, there was resolution of the hemorrhage and return of good visual acuity. At 10-year follow-up, visual acuity was 20/30 in the right eye. The second case was a 49-year old female with a history of presumed ocular histoplasmosis syndrome (POHS), presenting with sudden vision loss (20/400) in her right eye due to large, thick SMH. With observation and intermittent anti-VEGF therapy, there was resolution of the hemorrhage. At 30-year follow-up, visual acuity was 20/20 in the right eye.

Keywords: choroidal neovascularization, submacular hemorrhage, anti-VEGF, retinal toxicity, age-related macular degeneration, presumed ocular histoplasmosis syndrome

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