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Safety profile and surgical outcomes of early vitrectomy in eyes with unexplained fundus-obscuring vitreous haemorrhage

Eye volume 37, pages 3191–3196 (2023)Cite this article

Subjects

Abstract

Objectives

To investigate the safety profile and the surgical outcomes in a large cohort of subjects undergoing early vitrectomy for unexplained fundus-obscuring vitreous haemorrhage (FOVH).

Methods

Retrospective, single-centre case series of 186 consecutive eyes presenting between January 2018 and February 2020. Primary outcomes included change in best-corrected visual acuity (BCVA), rate of intra-operative retinal tears or retinal detachment (RD), baseline proliferative vitreoretinopathy (PVR), association of demographics with clinical outcomes, and rate of significant adverse events characterised by reoperation.

Results

Main final diagnosis was haemorrhagic posterior vitreous detachment (76%) and the overall risk of a retinal tear with or without RD found at the time of surgery was 69%. Vitrectomy was completed within 24 h in 94% of eyes. Rate of RD was 18%; all cases were macula-sparing with no PVR. Mean change in BCVA from baseline to final follow-up was −1.53 ± 0.69 LogMAR, p < 0.001. Time from presentation to surgery was significantly associated with final BCVA (p = 0.036, beta co-efficient 0.097). There was a significant association between presence of RD and age <60 y (OR 0.94, 95%CI [0.90–0.98], p = 0.003). 4.8% required repeated vitrectomy for post-operative RD (4), epiretinal membrane formation (3), removal of oil (1), and recurrent FOVH (1). None of these reoperations were induced by complications during the first surgery.

Conclusion

There is a high rate of retinal breaks in cases with unexplained FOVH, and the risk of a concomitant RD is higher in younger subjects. Early vitrectomy within 24 h appears a safe first-line treatment and yields good clinical outcomes.

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Fig. 1: Change in best-corrected visual acuity (BCVA).

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Data availability

The data that support the findings of this study are available on request from the corresponding author and approval by the Clinical Audit Committee. The data are not publicly available due to them containing information that could compromise research participant privacy.

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Author information

Authors and Affiliations

  1. Moorfields Eye Hospital NHS Foundation Trust, London, UK

    Blanca C. Flores-Sánchez, Edward Bloch, Priyanka Sanghi & Lyndon da Cruz

  2. University College London, Institute of Ophthalmology, London, UK

    Blanca C. Flores-Sánchez, Edward Bloch & Lyndon da Cruz

  3. National Institute for Health Research Biomedical Resource Centre at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK

    Edward Bloch & Lyndon da Cruz

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  1. Blanca C. Flores-Sánchez
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Contributions

PS: Acquired data. BFS: Acquired data; designed the work; drafted and revised the manuscript. EB: performed statistical analysis; performed an important role in interpreting the results. LdC: designed the work; approved the final version of the manuscript; ensured accuracy and integrity of the work.

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Correspondence to Blanca C. Flores-Sánchez.

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Flores-Sánchez, B.C., Bloch, E., Sanghi, P. et al. Safety profile and surgical outcomes of early vitrectomy in eyes with unexplained fundus-obscuring vitreous haemorrhage. Eye 37, 3191–3196 (2023). https://doi.org/10.1038/s41433-023-02475-2

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