VARIATIONS IN THE CLINICAL COURSE OF SUBMACULAR HEMORRHAGE

PURPOSE: To assess variations in the clinical course of submacular hem orrhages. METHODS: We reviewed fundus photography charts taken of pati ents during a 27-month period. Thirty-one eyes of 31 patients with sub macular hemorrhages under the foveal avascular zone were reviewed. RES ULTS: In 20 of the eyes, the underlying etiology was age related macul ar degeneration (ARMD). The other 11 eyes had various underlying condi tions, including macroaneurysms (two), presumed ocular histoplasmosis syndrome (two), trauma (one), Valsalva's retinopathy (one), idiopathic central serous choroidopathy (one), diabetic retinopathy (two), centr al retinal vein occlusion (one), and choroidal rupture (one). Of the e yes with ARMD (mean follow up, 29 months), eight (40%) of 20 showed an improvement in visual acuity (greater than or equal to 2 Snellen line s), six (30%) of 20 had a final visual acuity of 20/80 or better, and three (15%) had a final visual acuity of 20/40 or better (range, 20/25 to 20/80). Of the eyes without ARMD (mean follow up, 29 months), five (45%) of 11 had an improvement in visual acuity and five (45%) of 11 attained a final visual acuity of 20/40 or better (range, 20/20 to 20/ 40). The best predictive factor for poor final visual acuity was the p resence of a subretinal neovascular membrane. CONCLUSIONS: Patients wi th submacular hemorrhage may have spontaneous improvement in visual ac uity without surgery. Patients without subretinal neovascular membrane s had a better visual improvement rate.