Abstract： Objective: To investigate the hemorrhagic characteristics associated with the treatment prognosis of polypoidal choroidal vasculopathy (PCV) with subretinal hemorrhage. Methods: This was a prospective study. Patients who were included had been diagnosed with naïve PCV from January 2015 to December 2017 in the Eye Hospital, Wenzhou Medical University, and were followed up for at least 3 months after the treatment. The logarithm of the minimum angle of resolution (logMAR) visual acuity during the follow-up after treatment were compared with baseline in different groups: A hemorrhage area of >4 disc area (DA) or less, whether or not there was foveal involvement, and the location of the center of the subretinal hemorrhage based on the Early Treatment Diabetic Retinopathy Study (ETDRS) ring. Data were recorded and analyzed by mixed linear models. Results: One hundred twenty-two patients (124 eyes) were enrolled, including 84 males and 38 females. The mean age was 64.9±9.8 years. Subretinal hemorrhage was present in 69 eyes (55.6%) at baseline. Among them, a larger hemorrhage area (>4 DA) in 34 eyes (49.3%) showed poorer visual improvement during the follow-up period than a smaller hemorrhage area (≤4 DA) in 35 eyes (50.7%). The fovea was involved in 59 eyes (85.5%) and showed poorer visual improvement during the follow-up than 10 eyes without foveal involvement (F=3.92, P=0.01). Among the 59 eyes with foveal involvement, 25 eyes (42.4%) with the center of the hemorrhage located within ETDRS ring 1 showed poorer visual improvement than eyes with the central hemorrhage ring at 2 or beyond (F=2.23, P=0.05). Conclusion: Large area, foveal involvement, and proximity to the fovea are risk factors for the poor prognosis of PCV with subretinal hemorrhage.
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