Assessment of retinal pigment epithelium tears in eyes with submacular hemorrhage secondary to age-related macular degeneration

Abstract To assess retinal pigment epithelium (RPE) tears in eyes which underwent pars plana vitrectomy (PPV) for submacular hemorrhage (SMH) secondary to age-related macular degeneration and to investigate the prognostic factors of visual outcomes. This study was a retrospective, observational case...

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Main Authors: Tomoko Ueda-Consolvo, Syogo Takahashi, Toshihiko Oiwake, Tomoko Nakamura, Masaaki Ishida, Shuichiro Yanagisawa, Atsushi Hayashi
Format: Article
Language:English
Published: Nature Portfolio 2025-01-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-88128-8
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author Tomoko Ueda-Consolvo
Syogo Takahashi
Toshihiko Oiwake
Tomoko Nakamura
Masaaki Ishida
Shuichiro Yanagisawa
Atsushi Hayashi
author_facet Tomoko Ueda-Consolvo
Syogo Takahashi
Toshihiko Oiwake
Tomoko Nakamura
Masaaki Ishida
Shuichiro Yanagisawa
Atsushi Hayashi
author_sort Tomoko Ueda-Consolvo
collection DOAJ
description Abstract To assess retinal pigment epithelium (RPE) tears in eyes which underwent pars plana vitrectomy (PPV) for submacular hemorrhage (SMH) secondary to age-related macular degeneration and to investigate the prognostic factors of visual outcomes. This study was a retrospective, observational case series that included 24 eyes of 24 patients who underwent PPV with subretinal tissue plasminogen activator and air for SMH. RPE tears were investigated using spectral-domain or swept-source optical coherence tomography images with raster scan, combined confocal scanning laser ophthalmoscope near-infrared images and color fundus photographs. Multiple regression analysis was performed to identify the predictors of visual outcome at month 3 and 6 after surgery. In 21 eyes out of 24 eyes (87.5%), RPE tear was detected in the posterior pole. Eight eyes (33.3%) had large RPE tears ( ≧ 1 disc diameter (DD)). Out of the 8 eyes, 5 eyes progressed fibrotic scars within 3 months despite successful SMH removal and showed decrease in their visual acuity (VA). The ratio of eyes with large RPE tears ( ≧ 1DD) were significantly higher in eyes which had undergone anti-VEGF therapy within 3 months than in treatment-naïve eyes (71.4% vs. 25.0%, p = 0.048). The multiple regression analysis revealed that a small RPE tear (< 1DD) and treatment-naïve condition were associated with better VA at month 3 and 6. SMH within 3 months after anti-VEGF therapy might be accompanied by a large RPE tear. An RPE tear which was smaller than 1DD and treatment-naïve condition were associated with better prognosis.
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spelling doaj-art-1227bfb4527f4529a7c3481f25ab34fc2025-02-02T12:21:59ZengNature PortfolioScientific Reports2045-23222025-01-011511910.1038/s41598-025-88128-8Assessment of retinal pigment epithelium tears in eyes with submacular hemorrhage secondary to age-related macular degenerationTomoko Ueda-Consolvo0Syogo Takahashi1Toshihiko Oiwake2Tomoko Nakamura3Masaaki Ishida4Shuichiro Yanagisawa5Atsushi Hayashi6Department of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of ToyamaDepartment of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of ToyamaDepartment of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of ToyamaDepartment of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of ToyamaDepartment of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of ToyamaDepartment of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of ToyamaDepartment of Ophthalmology, Graduate School of Medicine and Pharmaceutical Sciences, University of ToyamaAbstract To assess retinal pigment epithelium (RPE) tears in eyes which underwent pars plana vitrectomy (PPV) for submacular hemorrhage (SMH) secondary to age-related macular degeneration and to investigate the prognostic factors of visual outcomes. This study was a retrospective, observational case series that included 24 eyes of 24 patients who underwent PPV with subretinal tissue plasminogen activator and air for SMH. RPE tears were investigated using spectral-domain or swept-source optical coherence tomography images with raster scan, combined confocal scanning laser ophthalmoscope near-infrared images and color fundus photographs. Multiple regression analysis was performed to identify the predictors of visual outcome at month 3 and 6 after surgery. In 21 eyes out of 24 eyes (87.5%), RPE tear was detected in the posterior pole. Eight eyes (33.3%) had large RPE tears ( ≧ 1 disc diameter (DD)). Out of the 8 eyes, 5 eyes progressed fibrotic scars within 3 months despite successful SMH removal and showed decrease in their visual acuity (VA). The ratio of eyes with large RPE tears ( ≧ 1DD) were significantly higher in eyes which had undergone anti-VEGF therapy within 3 months than in treatment-naïve eyes (71.4% vs. 25.0%, p = 0.048). The multiple regression analysis revealed that a small RPE tear (< 1DD) and treatment-naïve condition were associated with better VA at month 3 and 6. SMH within 3 months after anti-VEGF therapy might be accompanied by a large RPE tear. An RPE tear which was smaller than 1DD and treatment-naïve condition were associated with better prognosis.https://doi.org/10.1038/s41598-025-88128-8Submacular hemorrhageRetinal pigment epithelium tearPars plana vitrectomyTissue plasminogen activatorAge-related macular degeneration
spellingShingle Tomoko Ueda-Consolvo
Syogo Takahashi
Toshihiko Oiwake
Tomoko Nakamura
Masaaki Ishida
Shuichiro Yanagisawa
Atsushi Hayashi
Assessment of retinal pigment epithelium tears in eyes with submacular hemorrhage secondary to age-related macular degeneration
Scientific Reports
Submacular hemorrhage
Retinal pigment epithelium tear
Pars plana vitrectomy
Tissue plasminogen activator
Age-related macular degeneration
title Assessment of retinal pigment epithelium tears in eyes with submacular hemorrhage secondary to age-related macular degeneration
title_full Assessment of retinal pigment epithelium tears in eyes with submacular hemorrhage secondary to age-related macular degeneration
title_fullStr Assessment of retinal pigment epithelium tears in eyes with submacular hemorrhage secondary to age-related macular degeneration
title_full_unstemmed Assessment of retinal pigment epithelium tears in eyes with submacular hemorrhage secondary to age-related macular degeneration
title_short Assessment of retinal pigment epithelium tears in eyes with submacular hemorrhage secondary to age-related macular degeneration
title_sort assessment of retinal pigment epithelium tears in eyes with submacular hemorrhage secondary to age related macular degeneration
topic Submacular hemorrhage
Retinal pigment epithelium tear
Pars plana vitrectomy
Tissue plasminogen activator
Age-related macular degeneration
url https://doi.org/10.1038/s41598-025-88128-8
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