Disease activity after development of large subretinal hemorrhage in polypoidal choroidal vasculopathy

Purpose: To investigate changes in disease activity after a large subretinal hemorrhage in polypoidal choroidal vasculopathy. Methods: Fifty-two polypoidal choroidal vasculopathy eyes with large subretinal hemorrhage (at initial presentation [n = 33, Group 1] or developed during follow-up [n = 19, Group 2]) were enrolled. Thirty polypoidal choroidal vasculopathy eyes without subretinal hemorrhage were enrolled as controls. All subretinal hemorrhages were treated with pneumatic displacement. Other active lesions were treated with intravitreal ranibizumab on an as-needed basis. Injection-free period, 1-year injection numbers, and polyp presence on indocyanine green angiography were analyzed. Results: The injection frequency significantly diminished after hemorrhage (1.2 ± 1.8 in Group 1 and 1.1 ± 2.1 in Group 2) compared with control eyes (3.9 ± 3.0) in both groups (both P, 0.001) and the prehemorrhage period (4.7 ± 1.4) in Group 2 (P, 0.001). The median injection-free period after hemorrhage was 12.0 months in both groups. At least one polypoidal lesion disappeared after hemorrhage in 7 of 10 eyes (70%) with comparable indocyanine green angiography. Conclusion: The activity of a polypoidal choroidal vasculopathy lesion diminished after a large subretinal hemorrhage, which was associated with rupture of major polyps.