Long term outcome of early vitrectomy in non-diabetic, non-traumatic patients with acute posterior vitreous detachment (PVD) and vitreous hemorrhage

Abstract Objective: Evaluate the etiologies for dense vitreous hemorrhage in pseudophakic, non-diabetic and non-traumatic adults with acute PVD and the efficiency of early vitrectomy treatment.Methods: The study included 93 eyes of 93 patients and it consisted in the evaluation of etiologies of vitreous hemorrhage: retinal tears, retinal occlusion (RVO), choroidal neovascularization (CNV) and acute posterior vitreous detachment (PVD). A comparison of initial visual acuity versus final visual acuity post vitrectomy is performed.Results: The mean time between symptom onset and surgery was 6.9 days. The most common etiologies observed during this study were: retinal tear (63.4%), vein occlusion (18.3%), CNV (9.7%) and PVD (8.6%). Following early vitrectomy treatement, VA significantly improved from 1.673 LogMAR to 0.220 LogMAR. In addition, the incidence of retinal tears identified preoperatively by ocular ecography were 13, but it improved to 46 during surgery.Conclusion: Retinal tears, RVO, CNV and PVD were the most common causes of dense vitreous hemorrhage. Early vitrectomy has a good outcome with improvement on visual acuity and we also observed during surgery retinal tears not efficiently identified by ultrasound preoperatively.