Micro-invasive vitrectomy for vitreous hemorrhage secondary to retinal arterial macroaneurysm

Abstract

Objective To evaluate the safety and efficacy of micro-invasive vitrectomy combined with endophotocoagulation in cases with dense vitreous hemorrhage secondary to retinal arterial macroaneurysm. Methods Retrospective,consecutive,interventional cases series of 10 eyes of 10 patients with retinal arterial macroaneurysm who underwent 3-port pars plana vitrectomy and endophotocoagulation using 23-guage instrumentation combined with 25-gauge infusion.Follow-up ranged from 3 to 32 months (mean,18.6±10.03 months).Main outcome measures included pre and post operation best-corrected visual acuity (BCVA),intraocular pressure,and complications. Results The postoperative visual acuities improved in all eyes.The mean BCVA improved from 0.03±0.02 (ranged from hand motions to 0.06) preoperatively to 0.24±0.14 (ranged from 0.05 to 0.4) at the one week after surgery and there was a significant statistical difference between them (t =-4.72,P ＜0.01).At the final follow-up,the BCVA was 0.36±0.21 (ranged from 0.1 to 0.6),and vision was better than 0.3 in seven eyes.There was a significant statistical difference between pre-operation and the final follow-up (t =-4.94,P ＜0.01).The intraocular pressure of one day before operation,one day after operation,three day after operation and the final follow-up were (9.87±3.23),(11.91±4.66),(10.47±2.83),(ll.94±2.89)mmHg respectively,no statistically significant difference was found among them (F=0.895,P＞0.05).No serious complications and recurrenee occurred. Conclusions Micro-invasive vitrectomy combined with endophotocoagulation is a feasible treatment for cases with dense vitreous hemorrhage secondary to retinal arterial macroaneurysm. Key words: Micro-invasive vitrectomy; Endophotocoagulation; Vitreous hemorrhage; Retinal arterial macroaneurysm