Incidence of massive subretinal haemhorrage in retinal angiomatous proliferation

Session Details

Session Title: Free Paper Session 27: AMD VI

Session Date/Time: Sunday 10/09/2017 | 12:00-13:30

Paper Time: 12:06

Venue: Room 117

First Author: : J.Lee SOUTH KOREA

Co Author(s): :    M. Lee   W. Lee                          

Abstract Details

Purpose:

To evaluate the incidence and associated risk factors of massive subretinal haemhorrage (SRH) in patients with retinal angiomatous proliferation (RAP).

Setting:

Retrospective cohort study.

Methods:

A total of 187 eyes of 135 treatment-na─▒ve patients diagnosed with RAP were evaluated retrospectively. Clinical records including the time between the initial visit, last anti-vascular endothelial growth factor (VEGF) treatment, last stable examination, and the date of massive SRH were reviewed. Imaging findings including indocyanine green angiography (ICGA) and optical coherence tomography (OCT) were analyzed.

Results:

Massive SRH developed in 18 eyes (9.6%) a median of 20 months after the initial presentation. Kaplan-Meier survival analysis revealed that the incidence (2.8, 5.8, 13.1, and 21.0% after 1, 2, 5 and 10 years, respectively) continuously increased. Among 14 eyes with discernable vascular anastomosis on baseline ICGA, 13 (92.8%) showed retinal arteriole involvement. On spectral-domain OCT imaging of the last visit prior to the massive SRH, a layered lamellar tissue complex was noted under the retinal pigment epithelium in 9 of 13 eyes, which was significantly associated with massive SRH [hazard ratio(HR),5.883;P =.010]. The average time between the last stable examination/last injection and the massive SRH was 2 and 5 months, respectively. The patients were treated with anti-VEGF injection, gas and recombinant tissue plasminogen activator injection; however, all except one eye had visual acuity worse than 20/1000 at the final visit.

Conclusions:

Massive SRH can occur in RAP in the course of anti-VEGF treatment, resulting in severe vision loss. A proactive dosing regimen may be more appropriate for these RAP eyes.

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