Joseph Park, MBBS, FRANZCO, (London, UK), Hari Jayaram, MBBS (London, UK), Ed Schulenberg, FRCS, FRCOphth (London, UK), Graham Duguid, MD, FRCOphth (London, UK), Rahila Zakir, MBBS (London, UK)

PURPOSE:

To establish the etiology of non-diabetic vitreous hemorrhage (NDVH) requiring vitrectomy.

METHODS:

Retrospective chart review of 18 consecutive patients (19 eyes) presenting with NDVH to Western Eye Hospital, and requiring vitrectomy, over the 24 months period. The inclusion criteria were patients with either dense or non-dense NDVH requiring vitrectomy. The exclusion criteria were patients who had vitrectomy for diabetic vitreous hemorrhage (VH). Either the vitreo-retinal consultants or the fellows were the primary surgeons. Dense VH was defined as that which would not give clinical view of the retina. Non-dense VH was defined as that in which sufficient clinical details were visible in order to determine the cause of the NDVH. Statistical software, Prism, was used for the data analysis.

RESULTS:

The mean age of the study population was 58.9 years (95% CI, 47.6-70.3 years). There were 9 males (50%) and 9 females (50%). Thirteen eyes (68%) had dense VH and four eyes (21%) had non-dense VH. The mean final VA was 1.35 LogMar (<6/120 Snellen equivalent) in the dense VH group and the mean final VA was 0.33 LogMar (6/12 Snellen equivalent) in the non-dense VH group (p=0.05). Nine eyes (50%) had posterior vitreous detachment (PVD) and 61.5% of dense VH eyes had PVD on B-scan ultrasonography. Mean time before surgery was 5.9 months (95% CI, 1.0-10.8 months). Mean follow-up since vitrectomy was 6.1 months (95% CI, 3.7-8.2 months). BRVO was the commonest cause of non-clearing NDVH requiring vitrectomy in our cohort (7 eyes, 39%). 17% (3 eyes) had sickle cell retinopathy, 11% (2 eyes) had CNVMs, 5.5% (1 eye) had idiopathic vasculitis, 5.5% (1 eye) had CMV, 5.5% (1 eye) had hypertensive retinopathy, 5.5% (1 eye) had retinal tear, 5.5% (1 eye) had macroaneurysm and 5.5% (1 eye) had a PVD.

CONCLUSION:

The commonest cause of non-clearing NDVH requiring vitrectomy in our institution was branch retinal vein occlusion. Dense vitreous hemorrhage was predictor for poorer final visual outcomes.