Factors Prognostic of Visual Outcome in Patients With Subretinal Hemorrhage

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We reviewed the charts of 29 patients with large subretinal hemorrhages involving the center of the fovea to evaluate factors that might be prognostic of visual outcome. The average final visual acuity was 20/480 with a mean follow-up of three years. Patients with thick hemorrhages (causing an obvious elevation of the fovea) had worse final visual acuity than patients with thin hemorrhages (P = .02). The diameter of the hemorrhage was not a significant predictor of outcome. Patients with aging macular degeneration had poorer final visual acuity (mean, 20/1,700, P = .002), and patients with choroidal ruptures had better final visual acuity, (mean 20/35, P < .001) than the remainder of the patients. We found that the presence of aging macular degeneration was a more important predictor of the outcome of legal blindness than the thickness of the hemorrhage (P = .03). Although the prognosis in patients with subfoveal blood is generally poor, some patients have excellent return of vision.

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This study was presented in part at the annual meeting of the Association for Research in Vision and Ophthalmology, Sarasota, Florida, May 2, 1989. This study was supported in part by an unrestricted grant from Research to Prevent Blindness, Inc., New York, New York, and the Retina Research Fund of the University of Iowa.

Reprint requests to Christopher F. Blodi, M.D., Department of Ophthalmology, University of Iowa Hospitals, Iowa City, IA 52242.

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