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Treatment of submacular hemorrhage with tissue plasminogen activator and pneumatic displacement in age-related macular degeneration.

Abstract：

PURPOSE:To evaluate visual and anatomic outcomes following pars plana vitrectomy and intravitreal or subretinal tissue plasminogen activator for submacular hemorrhage in patients with age-related macular degeneration. METHODS:This was a retrospective study on patients with a minimum follow-up of 12 months undertaken at a tertiary referral center. Data collected include demographic details, visual and optical coherence tomography changes, surgical details, and complications. Surgical results were compared with patients who were age and lesion size matched and treated with anti-vascular endothelial growth factor injections alone. RESULTS:There were 36 patients in surgical and 18 patients in control group. Patients in surgical arm had pars plana vitrectomy, intravitreal tissue plasminogen activator with air 24 (67%), 6 (16%) with C3F8 gas, 1 (3%) with SF6 gas, 4 (11%) subretinal tissue plasminogen activator with air, and 1 (3%) with C2F6 as post-operative tamponade. Mean LogMAR in tissue plasminogen activator group at baseline was 1.56, and it was improved at all time points 1.06 at 1 month (p < 0.05), 0.91 at 6 months (p < 0.05), and 1.07 at 1 year (p < 0.05). Mean best corrected visual acuity in control group at baseline was 1.22LogMAR with no significant improvement at any time points: 1 month (1.27), 6 months (1.35), and 12 months (1.36). Complications included retinal detachment 5%, vitreous hemorrhage 7.5%, and cataract 19%. CONCLUSION:Pars plana vitrectomy with intravitreal (or subretinal) tissue plasminogen activator and pneumatic displacement can offer better outcome in comparison to anti-vascular endothelial growth factor alone in patients with submacular hemorrhage secondary to age-related macular degeneration.

journal_name

Eur J Ophthalmol

journal_title

European journal of ophthalmology

authors

Sniatecki JJ,Ho-Yen G,Clarke B,Barbara R,Lash S,Papathomas T,Antonakis S,Gupta B

doi

10.1177/1120672119891625

subject

Has Abstract

pub_date

2019-12-09 00:00:00

pages

1120672119891625

eissn

1120-6721

issn

1724-6016

pub_type

杂志文章

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Treatment of submacular hemorrhage with tissue plasminogen activator and pneumatic displacement in age-related macular degeneration.