BULLOUS HEMORRHAGIC RETINAL DETACHMENT BECAUSE OF MASSIVE SUBRETINAL HEMORRHAGE IN PATIENTS WITH AGE-RELATED MACULAR DEGENERATION

Abstract

Purpose: The authors investigated the surgical outcomes of massive subretinal hemorrhage draining via a retinotomy procedure in bullous hemorrhagic retinal detachment (HRD). Methods: Clinical records of consecutive patients with age-related macular degeneration who underwent surgery for bullous HRD were reviewed. Outcomes included anatomical success, visual acuity, and postoperative complications. Results: Seventeen consecutive eyes of 17 patients were included in this series. Of the 17 eyes, 8 eyes had total HRD and 9 eyes had half total inferior HRD including the macula. The mean interval between initial symptom presentation and operation was 22.6 +/- 11.7 days. All patients underwent pars plana vitrectomy and internal drainage of the subretinal hemorrhage through a posterior drainage retinotomy. The mean follow-up period was 37.1 months (range, 12-66 months). Finally, successful retinal reattachment was achieved in 15 of the 17 eyes (88.2%), but 2 remained nonprogressive localized inferior retinal detachment because of proliferative vitreoretinopathy. All preoperative visual acuities were hand movements or worse, and 10 eyes (58.8%) achieved a postoperative minimum functional vision of 20/1000 or better. Conclusion: Successful retinal reattachment and achievement of minimum functional vision is possible after PPV and retinotomy with evacuation of a massive subretinal hemorrhage for bullous HRD secondary to age-related macular degeneration.