Su Jin Lim, Sun Hyun Kim, Oh Woong Kwon (Seoul, South Korea)

Advantages:

To study the clinical feature of vitreous hemorrhage after intravitreal anti-VEGF injection for age-related macular degeneration

Methods:

6 eyes of 6 patients who had vitreous hemorrhage after intravitreal anti-VEGF injection were studied. Their medical records were reviewed and course and characteristics were studied.

Effectiveness / Safety:

4 eyes were diagnosed as polypoidal choroidal vasculopathy (PCV), 1 eye had an occult CNV and in 1 eye PCV could not be excluded. Mean visual acuity before injection was 0.87¡≤0.51. In fundus examination large subretinal hemorrhage of more than 4 disc diameter was noticed in all eyes. Mean duration from injection to development of vitreous hemorrhage was 9.3¡≤4.0 days. In all 6 eyes vitreous hemorrhage was too dense to visualize fundus and 6 eyes underwent pars plana vitrectomy. During the vitrectomy diffuse hemorrhagic retina detach was noticed in 4 of 6 eyes. 6 eyes had visual acuity of worse than CF before vitrectomy and 2 of 6 eyes showed visual acuity of better than CF.

Take home message:

Massive vitreous hemorrhage could be a significant adverse event following intravitreal anti-VEGF injection especially in PCV or occult CNV with previous large subretinal hemorrhage.