Outcomes of Vitrectomy for Non-Traumatic Non-Diabetic Vitreous Hemorrhage

Purpose: To determine the causes of non-traumatic non-diabetic vitreous hemorrhage(NDVH) and to report the visual and anatomical outcomes and complications ofvitrectomy for this condition.Method: In a retrospective case series, records of patients who had undergonevitrectomy for non-traumatic NDVH over a ten year period at Labbafinejad MedicalCenter, Tehran-Iran with at least six months of follow up were reviewed for causes ofthe condition and outcomes of surgery.Results: From 1993 to 2003, 50 eyes of 49 patients (51% male) with mean age of 62.7±10.3(range 35-87) years underwent vitrectomy for non-traumatic NDVH. Preoperatively,mean best-corrected visual acuity (BCVA) was 2.36±0.52 LogMAR and relative afferentpupillary defect was positive in 91.1% of the eyes. Mean BCVA increased significantly to1.38±0.72 LogMAR at six months (P 0.0001). Causes of non-traumatic NDVH included:branch retinal vein occlusion (56%), central retinal vein occlusion (16%), choroidalneovascularization (12%) and posterior vitreous detachment with retinal break, Eales’disease, familial exudative vitreoretinopathy and Terson’s syndrome (each in 4%). Themost common causes of poor visual outcomes were: macular pigmentary derangement(26%), optic atrophy (16%), severe lens opacity (12%) and epiretinal membrane (8%).Conclusion: Despite the significant increase in VA following vitrectomy, irreversiblemacular or optic nerve pathology limits significant improvement in central visual acuityin several cases of non-traumatic NDVH. Vascular accidents were the most commoncause of this condition.