Causes and Results of Vitrectomy for Spontaneous Non-Diabetic Vitreous Hemorrhage

To determine the visual and anatomical outcomes and complications of vitrectomy for non-traumatic non-diabetic vitreous hemorrhage (NDVH) and to report the causes of the condition among patients at Labbafinejad Medical Center, Tehran-Iran, from 1993 to 2003. Records of patients who underwent vitrectomy for non-traumatic NDVH with 6 months follow up were reviewed for demographic characteristics, causes of NDVH and results of surgery. Fifty eyes (54.2% right eyes) of 49 patients (51% male) with mean age of 62.710.3 years were enrolled in the study. Mean visual acuity (VA) was 2.360.52 LogMAR and relative afferent pupillary defect (RAPD) was positive in 91.7% of the eyes, preoperatively. Causes of non-traumatic NDVH detected intraoperatively were: branch retinal vein occlusion (56%), central retinal vein occlusion (16%), choroidal neovascularization (12%), and posterior vitreous detachment with break, Eales disease, familial exudative vitreoretinopathy, and Terson syndrome (each in 4%). Mean VA increased significantly at 6th month (1.380.72 logMAR) compared to preoperative value. (P<0.0001) The most common causes of decreased VA were: macular pigmentary derangement (26%), optic atrophy (16%), severe lens opacity (12%), and epiretinal membrane (8%). Despite the statistically significant increase in mean VA following vitrectomy, underlying macular pathology limits significant improvement of central VA in most cases of non-traumatic NDVH.