Anti–Vascular Endothelial Growth Factor Monotherapy in the Treatment of Submacular Hemorrhage Secondary to Polypoidal Choroidal Vasculopathy

Abstract

To evaluate the effect of intravitreal anti-vascular endothelial growth factor (VEGF) injections on submacular hemorrhage secondary to polypoidal choroidal vasculopathy. Retrospective, interventional case series. Twenty-seven eyes from 27 polypoidal choroidal vasculopathy patients with submacular hemorrhage involving the fovea were included in the analyses. All patients were treated by anti-VEGF injection with an initial 3 loading injections by month, followed by an as-needed reinjection. Visual acuity, central macular thickness, submacular hemorrhage size, and the occurrence of vitreous hemorrhage were examined during a 12-month follow-up period. The mean number of injections administered over the course of 12 months was 3.59 ± 1.04. The size of submacular hemorrhages averaged 18.2 ± 13.8 mm². The mean logarithm of the minimal angle of resolution (logMAR) visual acuity at baseline was 1.02 ± 0.51 (Snellen equivalent, 20/204) and improved significantly to 0.76 ± 0.48 (Snellen equivalent, 20/115) at 12 months (P = .02). Mean central macular thickness decreased from 311.7 ± 124.5 μm at baseline to 246.8 ± 102.8 μm at 12 months (P = .01). At 12 months, visual acuity improved by 0.3 logMAR or more in 10 eyes (37%), stabilized (change between 0 and 0.3 logMAR) in 11 eyes (40.7%), and decreased by 0.3 logMAR or more in 6 eyes (22.2%). Three eyes (11.1%) were subjected to vitrectomy to clear a vitreous hemorrhage that occurred after anti-VEGF therapy. Intravitreal anti-VEGF injection monotherapy may be a valuable therapeutic option in treating eyes with submacular hemorrhage associated with polypoidal choroidal vasculopathy.