Natural history of vitreous hemorrhage in diabetic retinopathy.

Eighty-five eyes with severe vitreous hemorrhage on initial visit were followed for three to ten years without treatment. A comparison of initial and final visual acuities showed vision to have worsened in 36 eyes (42%), improved in 25 eyes (30%) and remained unchanged in 24 eyes (28%). Vision in 60 eyes was 5/200 or worse when last examined. Of 42 eyes followed three to six years (group 1), the low vision in 24 eyes (57%) was due to vitreous hemorrhage, while of 18 eyes that were followed seven to ten years (group 2), six (33%) had low vision due to vitreous hemorrhage. Traction detachments were found in five eyes (28%) in group 2 as compared with three (7%) in group 1. The prognosis for clearing of the hemorrhage was better when the fundus reflex was brighter and the retina adjacent to the ora serrata was visible. Clearing occurred sooner when the hemorrhage was retrohyaloid rather than in the vitreous gel. The study showed that ultimately 68% of the eyes had a visual acuity of 5/200 or worse.