Abstract
Background
Early vitrectomy for complete fundus-obscuring vitreous haemorrhage (VH) allows for prompt diagnosis and treatment of the cause.
Aims
To analyse the causes of VH of unknown aetiology, whether partially fundus-obscuring or dense, and to determine the outcomes of early vitrectomy.
Methods
A retrospective review of patients who underwent early vitrectomy within 10 days of symptom-onset for partially fundus-obscuring or dense VH of unknown origin. Patients with evidence of proliferative diabetic retinopathy in either eye or any other preoperatively diagnosed aetiology of VH were excluded.
Results
19 patients were included. Intraoperative diagnoses were: retinal tears without rhegmatogenous retinal detachment (RRD) (53%); peripheral localised RRD (32%); neovascularisation secondary to retinal vein occlusion (11%) and posterior vitreous detachment without a retinal break (5%). Patients with diffuse VH were as likely to have a retinal tear diagnosed as those with dense VH (88% vs 82%, respectively; p = 0.7). Mean VA improved from 1.26 LogMAR to 0.23 LogMAR postoperatively (p = 0.001). 1 patient (5%) developed a RRD one-year postoperatively.
Conclusions
In cases of diffuse or dense VH of unknown aetiology, an occult retinal tear should be suspected. Early vitrectomy should be strongly considered regardless of whether the fundal view is partially or completely obscured, to prevent progression to visually significant RRDs.
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Data availability
Data will be available from the corresponding author upon reasonable request.
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M.M.O’R. designed the study, collected, and analysed data, and wrote the manuscript. G.A.M. collected data and made critical revisions to the manuscript. K.P.K. performed the vitrectomies, designed the study, and made critical revisions to the manuscript. All authors have read and agreed to the published version of the manuscript.
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This study adhered to the tenets of the Declaration of Helsinki. The study protocol was reviewed and approved by the Research Ethics Committee of the University of Limerick Hospitals Group, with the registration number 137/2022. Informed consent was waived as this is a retrospective study.
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O’Riordan, M.M., McCabe, G.A. & Kennelly, K.P. Early vitrectomy is indicated for both diffuse and dense vitreous haemorrhages of unknown aetiology. Ir J Med Sci (2023). https://doi.org/10.1007/s11845-023-03573-6
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DOI: https://doi.org/10.1007/s11845-023-03573-6