Efficacy analysis of deuterium oxide-assisted vitrectomy combined with external scleral drainage for
massive sub-macular hemorrhage in polypoidal choroidal vasculopathy
JIANG Heng, LUO Hongbo,ZHENG Qingqing, LI Xiaoxia, LIU Hui.
Department of Ophthalmology, Zhejiang Provincial People’s Hospital,People’s Hospital of Hangzhou Medical College, Hangzhou 310014, China
JIANG Heng,LUO Hongbo,ZHENG Qingqing, et al. Efficacy analysis of deuterium oxide-assisted vitrectomy combined with external scleral drainage for
massive sub-macular hemorrhage in polypoidal choroidal vasculopathy[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2024, 54(1): 36-41.
Abstract：Objective: To investigate the clinical efficacy of deuterium oxide -assisted vitrectomy combined with external scleral drainage for massive sub-macular hemorrhage caused by polypoidal choroidal vasculopathy (PCV). Methods: Retrospective analysis was performed in the hemorrhagic PCV patients with vitrectomy from Zhejiang Provincial People’s Hospital between January 2017 and 2022. Patients were divided into two groups:vitrectomy alone (28 eyes) and deuterium oxide-assisted vitrectomy combined with external scleral drainage surgery (28 eyes). The best-corrected visual acuity (BCVA), centre macular thickness (CMT), regression of polypoid vascular lesions and complications were observed pre- and post-operation in both groups. Results: The BCVA of the combined group improved after treatment compared with the baseline at the 1st, 3rd, 6th and 12th months (P<0.05), while the BCVA of the single vitrectomy group decreased compared with pre-operation at the 1st and 3rd months post-operation (P<0.05), and it increased significantly at the 6th and 12th months post-operation (P<0.05). The BCVA of the combined group was all better than that of the single vitrectomy group at the 1st,3rd, 6th and 12th months post-operation (P<0.05). CMT of the combined group and the single vitrectomy group all decreased significantly compared with the pre-operation at the 1st, 3rd, 6th and 12th months post-operation (P<0.05). And the CMT of the combined group were all lower than that of the single vitrectomy group at every follow-up point (P< 0.05). At 6th months post-operation, polypoid vascular lesion had basically regressed in 4 patients in the combined group, only one polypoid vascular lesion in the single vitrectomy group had regressed significantly, and no statistical difference existed between the two groups (P=0.349). At 12th months postoperation,polypoid vascular lesion had completely regressed in 8 patients in the combined group, 4 polypoid vascular lesions had regressed in the single vitrectomy group, and had no statistical difference between the two groups (P=0.193). Anterior chamber hemorrhage and secondary glaucoma complications didn’t occurred in the combined group during the treatment period; 10 eyes in the single vitrectomy group developed significant anterior chamber hemorrhage and secondary glaucoma after the operation, which turned better after anterior chamber irrigation and IOP-lowering medication. Conclusion: Compared with the single vitrectomy, deuterium oxideassisted vitrectomy combined with external scleral drainage is more effective in improving patients’ visual acuity and reducing CMT in patients with hemorrhagic PCV, more complete hemorrhage drainage, less postoperative sub-macular blood accumulation, and decreased postoperative complications.
