A Study Of Clinical Profile And Visual Outcome In Patients Undergoing Vitrectomy For Vitreous Hemorrhage

Abstract

Background: Aim & Objective: To study the epidemiology of vitreous hemorrhage in patients presenting without retinal detachment. To study various etiology of vitreous hemorrhage. To study visual outcome in patients with non resolving vitreous hemorrhage required vitrectomy surgery. To study prognostic factors (age, sex, and vitreous hemorrhage in diabetic patients, hypertensive patients, ARMD, Eales diseases) affecting visual outcome in vitreous hemorrhage. Material And Methods: Study included34 patients out of which 13 have diabetes, 6 have hypertension, 7 have both diabetes and hypertension, 6 have past history of tuberculosis and 2 have no systemic illness. Examination included preoperative and postoperative best corrected visual acuity, slit lamp examination, intraocular pressure, ultrasound B scan and dilated fundus with indirect ophthalmoscope. Result: Majority patients (38.2%) were in the age group of 51-60 years with the mean age 51.35 years. Males [73.5%] had higher incidence of vitreous hemorrhage than females and Incidence of vitreous hemorrhage was higher in lower socio-economic group. Diabetes Mellitus and Hypertension were the most common co-morbidities with Proliferative diabetic retinopathy, Eales diseases and Branch Retinal vein occlusion are the important Risk factors for vitreous hemorrhage. Most common presenting symptom of vitreous hemorrhage is sudden loss of vision [52.9%] followed by gradual loss of vision and blurring loss of vision. Patients who received pan retinal photocoagulation and Anti-vegf have better visual outcome post-operativel. Pan retinal photocoagulation, Epiretinal membrane, traction band, macular edema, and choroidalneo vascular membrane are the intra operative findings noted intra-operatively. Preoperatively most of the cases of vitreous hemorrhage had visual acquity in the group of Perception of light and finger counting close to face. Post-operatively 15 patients have visual acuity in group of 6/18-6/9.Among them 8 were PDR,4 cases of Eales disease and 3 were BRVO cases. Visual acuity of 8 cases belongs to group of 6/60 – 6/24 which include 5 PDR , 2 BRVO and 1 Eales disease. Post-operatively 7 patients developed complications. Raised IOP seen in 3 cases which includes 2 PDR cases and 1 Eales disease.Cataractous lens noticed in 2 PDR cases. Retinal detachment developed in 1 PDR case. Revitreous hemorrhage occurred in 1 Eales disease. 2 cases underwent re-surgery. Revitrectomy done in 1 case of Eales disease for re-vitreous hemorrhage. Re-vitrectomy with silicone oil insertion done in 1 PDR case for retinal detachment. Conclusion: Visual impairment due to Vitreous hemorrhage may be prevented by early detection of cause by appropriate investigations and treatment. [Kumar A Natl J Integr Res Med, 2021; 12(5): 7-10]