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목적 : To compare the long-term treatment outcome of intravitreal bevacizumab (IVB) monotherapy to combinations with either pneumatic displacement (PD) or vitrectomy in treating massive submacular hemorrhage(SMH) due to polypoidal choroidal vasculopathy (PCV).
방법 : A retrospective chart review was performed on 39 eyes of 37 Korean patients with massive SMH secondary to PCV. Twenty eyes were treated with IVB alone, 8 eyes were treated with combined PD and IVB, and 11 with combined vitrectomy and IVB. SMH larger than 2-disc diameters including the fovea area was defined as massive SMH. Best-corrected visual acuity (BCVA) and central foveal thickness (CFT) were measured at baseline and at 1, 6, 12, and 24 months after initial treatment. Secondary outcome measures included recurrence rate, integrity of central IS/OS line, and complications.
결과 : There was no statistical difference in final BCVA among the three treatment groups (p=0.061). Final improvement in BCVA was noted in IVB only (p=0.001), combined PD (p=0.046), and combined vitrectomy (p=0.017) but was not statistically significant (p=0.278). Massive SMH recurrence was observed in 2 eyes after IVB monotherapy and 7 eyes after combined PD (p=0.02). Breakthrough vitreous hemorrhage was noted in 10 eyes, 7 of whom received vitrectomy (p=0.006).
결론 : In terms of final BVCA, IVB monotherapy appears as effective as combination therapies in treating PCV with massive SMH, with decreased chance of complications associated with PD or vitrectomy.
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