Early Vitrectomy for Spontaneous, Fundus-Obscuring Vitreous Hemorrhage

Purpose To examine the visual outcomes of early intervention in the setting of fundus-obscuring vitreous hemorrhage (VH) presumed to be due to posterior vitreous detachment. Design Retrospective comparative case series. Methods All eyes that presented with a fundus-obscuring VH, defined as vision of 20/400 or worse and requiring a B-scan at presentation from 2003 to 2013, were evaluated. Eyes with any history of retinopathy, macular degeneration, recent trauma, presentation greater than 2 weeks after onset of symptoms, or follow-up of less than 2 months were excluded. The main outcome measure studied was final best-corrected visual acuity (BCVA) as dependent on the time to surgery. Results Ninety-two eyes met inclusion criteria with a mean follow-up of 490 days. Initial BCVA was logMAR 2.218 (Snellen equivalent 20/3000-20/4000, range 20/400-light perception); final BCVA was 0.318 (Snellen equivalent of 20/40-20/50, range 20/20-light perception, P < .001). Fifty-six patients (60.8%) had either a retinal tear or a retinal detachment. Patients who underwent surgery within 1 week had no significant improvement over all others; however, a significant improvement was found when comparing early vs delayed surgery groups ( P