심한 비당뇨성 유리체출혈의 술 후 원인분석 및 결과

Abstract

To evaluate the cause and the surgical outcome of dense vitreous hemorrhage occurred in nondiabetic patients, we performed a retrospective review on 36 eyes with dense nondiabetic vitreous hemorrhage that persisted for more than 3 months and underwent pars plana vitrectomy. Causes of vitreous hemorrhage, visual outcome, intraoperative and postoperative complications, and factors associated with poor visual outcome were evaluated. The etiology of the hemorrhage were branch retinal vein occlusion (16 eyes), Terson’s syndrome (5 eyes), retinal vasculitis (4 eyes), choroidal neovascularization (3 eyes), trauma (2 eyes), central retinal vein occlusion (2 eyes), retinal tear (2 eyes), pars planitis (1 eyes), and unknown (1 eyes). The final visual acuity after vitrectomy improved in 28 eyes (77.8%), and improved two lines or more in 22 eyes (61.1%). The cause of poor visual outcome were macular degeneration (3 eyes), proliferative vitreoretinopathy (2 eyes), neovascular glaucoma (2 eyes), cataract (2 eyes), macualr hole (1 eyes), recurred vasculitis (1 eyes). The main cause of proliferative vitreoretinopathy was iatrogenic retinal tear(s) occurred during epiretinal membrance dissection and peripheral vitrectomy. Final visual acuity following vitrectomy for dense nondiabetic vitreous hemorrhage depended on the underlying causes, status of macula, and surgical complications. Vitrectomy would be considered earlier to preserve visual function if vitreous hemorrhage is dense enough to prevent the funds examination and we should pay attention not to make iatrogenic retinal tear(s) during the surgeries.