Hypertension as a risk factor for recurrent subretinal hemorrhage in polypoidal choroidal vasculopathy

Abstract

OBJECTIVE: To investigate the relationship between hypertension and recurrent subretinal hemorrhage (SRH) in eyes with polypoidal choroidal vasculopathy (PCV). DESIGN: Retrospective, comparative case series. PARTICIPANTS: Thirty-eight eyes of 38 patients with PCV. METHODS: Ocular findings and clinical features were analyzed retrospectively in patients with PCV enrolled from January 2011 to December 2013. The patients were divided into 2 groups according to the presence of recurrent SRH after successful initial treatment (rebleeding vs nonrebleeding) and were subdivided into those with and without hypertension, based on history of hypertension, systolic blood pressure (SBP) >150 mm Hg. The relationship between hypertension and recurrent SRH was analyzed. RESULTS: Thirty-eight patients (38 eyes) were included in this analysis. High SBP or history of hypertension was significantly more frequent in the rebleeding group than in the nonrebleeding group (p = 0.014). Subgroup analysis showed that mean time until recurrent SRH was significantly shorter in the hypertensive group than in the nonhypertensive group (p = 0.025). The cumulative incidence of recurrent SRH at 2 years was 43% in the hypertensive group and 20% in the nonhypertensive group. Cox regression after adjustment for age showed that hypertension was associated with a 3.9-fold greater risk of recurrent SRH (p = 0.039). CONCLUSIONS: Recurrent SRH in patients with PCV was more common in hypertensive subjects. Undiagnosed hypertension should be considered when assessing the prognosis of patients with PCV.