The Role of Head Elevation in Treatment of Vitreous Haemorrhage

Pear Pongsachareonnont, Nattadet Rattana-aram, Thanapong Somkijrungroj Vitreoretinal Research Unit, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, ThailandCorrespondence: Pear PongsachareonnontDepa...

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Main Authors:	Pongsachareonnont P, Rattana-aram N, Somkijrungroj T
Format:	article
Language:	EN
Published:	Dove Medical Press 2020
Subjects:	vitreous haemorrhage head elevation visual acuity fundus colour intensity Ophthalmology RE1-994
Online Access:	https://doaj.org/article/d0b4bd84b7914c37b6b16dd2d6bcd37c
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spelling	oai:doaj.org-article:d0b4bd84b7914c37b6b16dd2d6bcd37c2021-12-02T04:40:52ZThe Role of Head Elevation in Treatment of Vitreous Haemorrhage1177-5483https://doaj.org/article/d0b4bd84b7914c37b6b16dd2d6bcd37c2020-01-01T00:00:00Zhttps://www.dovepress.com/the-role-of-head-elevation-in-treatment-of-vitreous-haemorrhage-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Pear Pongsachareonnont, Nattadet Rattana-aram, Thanapong Somkijrungroj Vitreoretinal Research Unit, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, ThailandCorrespondence: Pear PongsachareonnontDepartment of Ophthalmology, King Chulalongkorn Memorial Hospital, 1873 RamaIV Road Payathai, Bangkok 10330, ThailandTel +66 2 256 4144 ext 0Email pear.p@chulahospital.orgObjective: To investigate the effect of head elevation on macular clearance of acute vitreous haemorrhage.Design: Crossover, prospective, randomized clinical study.Setting: University, tertiary care hospital.Participants: 24 vitreous haemorrhage patients, average age 55 years.Methods: Patients with acute vitreous haemorrhage who were randomly separated into 2 groups. In group A, the patients were assigned normal head position for the first week of sleep, then switched to head elevation for the second week (n=12). In group B, the patients were assigned the head position in reverse order (n=12). A washout period of 24 hrs was used between treatments. The carryover, sequence, and treatment effects were analysed by using various mixed models.Outcomes: Best-corrected visual acuity (BCVA), vitreous haemorrhage grading, fundus photo colour intensity, and self-assessment scores.Results: Although the mean BCVA (LogMAR) change following head elevation was higher than following normal head position, the difference was not statistically significant (−0.053 and 0.065 LogMAR, respectively, p = 0.2). Vitreous haemorrhage grading in the central region showed no statistical improvement in either group. Fundus photo colour intensity comparison in all fundus areas also showed no statistically significant differences in either group.Conclusion: Although head elevation is recommended to patients with acute vitreous haemorrhage, this study showed no statistically significant improvement in BCVA, vitreous haemorrhage grading, or fundus photo colour intensity between head elevation and normal head position in the early observation period.Trial registration: TCTR20150314001.Keywords: vitreous haemorrhage, head elevation, visual acuity, fundus colour intensityPongsachareonnont PRattana-aram NSomkijrungroj TDove Medical Pressarticlevitreous haemorrhagehead elevationvisual acuityfundus colour intensityOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 14, Pp 7-13 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	vitreous haemorrhage head elevation visual acuity fundus colour intensity Ophthalmology RE1-994
spellingShingle	vitreous haemorrhage head elevation visual acuity fundus colour intensity Ophthalmology RE1-994 Pongsachareonnont P Rattana-aram N Somkijrungroj T The Role of Head Elevation in Treatment of Vitreous Haemorrhage
description	Pear Pongsachareonnont, Nattadet Rattana-aram, Thanapong Somkijrungroj Vitreoretinal Research Unit, Department of Ophthalmology, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, ThailandCorrespondence: Pear PongsachareonnontDepartment of Ophthalmology, King Chulalongkorn Memorial Hospital, 1873 RamaIV Road Payathai, Bangkok 10330, ThailandTel +66 2 256 4144 ext 0Email pear.p@chulahospital.orgObjective: To investigate the effect of head elevation on macular clearance of acute vitreous haemorrhage.Design: Crossover, prospective, randomized clinical study.Setting: University, tertiary care hospital.Participants: 24 vitreous haemorrhage patients, average age 55 years.Methods: Patients with acute vitreous haemorrhage who were randomly separated into 2 groups. In group A, the patients were assigned normal head position for the first week of sleep, then switched to head elevation for the second week (n=12). In group B, the patients were assigned the head position in reverse order (n=12). A washout period of 24 hrs was used between treatments. The carryover, sequence, and treatment effects were analysed by using various mixed models.Outcomes: Best-corrected visual acuity (BCVA), vitreous haemorrhage grading, fundus photo colour intensity, and self-assessment scores.Results: Although the mean BCVA (LogMAR) change following head elevation was higher than following normal head position, the difference was not statistically significant (−0.053 and 0.065 LogMAR, respectively, p = 0.2). Vitreous haemorrhage grading in the central region showed no statistical improvement in either group. Fundus photo colour intensity comparison in all fundus areas also showed no statistically significant differences in either group.Conclusion: Although head elevation is recommended to patients with acute vitreous haemorrhage, this study showed no statistically significant improvement in BCVA, vitreous haemorrhage grading, or fundus photo colour intensity between head elevation and normal head position in the early observation period.Trial registration: TCTR20150314001.Keywords: vitreous haemorrhage, head elevation, visual acuity, fundus colour intensity
format	article
author	Pongsachareonnont P Rattana-aram N Somkijrungroj T
author_facet	Pongsachareonnont P Rattana-aram N Somkijrungroj T
author_sort	Pongsachareonnont P
title	The Role of Head Elevation in Treatment of Vitreous Haemorrhage
title_short	The Role of Head Elevation in Treatment of Vitreous Haemorrhage
title_full	The Role of Head Elevation in Treatment of Vitreous Haemorrhage
title_fullStr	The Role of Head Elevation in Treatment of Vitreous Haemorrhage
title_full_unstemmed	The Role of Head Elevation in Treatment of Vitreous Haemorrhage
title_sort	role of head elevation in treatment of vitreous haemorrhage
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/d0b4bd84b7914c37b6b16dd2d6bcd37c
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The Role of Head Elevation in Treatment of Vitreous Haemorrhage

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