Early vitrectomy for fundus-obscuring dense vitreous haemorrhage from presumptive retinal tears

A retrospective review of all patients who underwent early vitrectomy for vitreous haemorrhage associated with posterior vitreous detachment was carried out. A comparison of initial visual acuity versus final visual acuity after vitrectomy was performed. The number of eyes that were found to have retinal tears and retinal detachment were documented. Initial and final Snellen acuities were used for statistical analysis. Categorical data were analysed using Fisher’s exact test and statistical significance was considered to be p<0.05.

Sixteen eyes were identified and all these patients presented or were referred soon after the onset of vitreous haemorrhage. Associated ocular pathology (choroidal neovascular membrane, retinal branch vein occlusion, macroaneurysm) was suspected to be the source of the haemorrhage in 4 eyes. Vitrectomy was carried out in 12 eyes soon after presentation (mean time 6.3 days, range 1–28 days). Nineteen retinal breaks were seen in these eyes and 5 eyes had more than two breaks. None of the eyes were found to have proliferative vitreo-retinopathy at the time of surgery. Two eyes needed repeat surgery for new retinal breaks. Excluding the eyes found to have an ocular pathology as the cause of vitreous haemorrhage, the mean visual acuity improved from hand movements to 6/12 (p<0.001).