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TitelSubretinal tissue plasminogen activator injection to treat submacular hemorrhages in age-related macular degeneration.
DoelTo determine the efficacy and safety of 23G transconjunctival sutureless vitrectomy (TSV), subretinal tissue plasminogen activator injection (tPA) and pneumatic displacement with air/SF6 gas to treat submacular hemorrhages secondary to AMD.
MethodesRetrospective analysis of 74 patients (mean age 79.3 years), surgically treated for submacular hemorrhage caused by neovascular AMD between November 2008 and July 2012 at the University Hospitals Leuven.
Main outcome measures: Short-term, best and final postoperative visual acuity, displacement of subretinal hemorrhage, and surgical complications.
ResultatenThe submacular hemorrhage was successfully displaced in 86% of the patients. After the surgery, the visual acuity improved by 0.34 logMAR unit after two months and by 0.06 logMAR unit at the final visit (mean follow up 241 days). The best postoperative visual acuity increased by 0.46 logMAR unit. Complications consisted of 9 cases of recurrent hemorrhage, 2 vitreous hemorrhages, 7 cases of retinal detachment, and 2 subchoroidal hemorrhages during the follow-up period.
ConclusieThis study indicates that a surgical approach with 23G TSV, tPA and pneumatic displacement may be an effective procedure for submacular hemorrhage displacement in patients with AMD. The procedure induced an improved visual recovery. However, visual outcome is limited by the underlying macular pathology. Larger multicenter randomized controlled studies are warranted to determine the therapeutic effect of this surgical approach.
Auteur 1
NaamDEWILDE
InitialenE
InstituutAfdeling Oogheelkunde UZLeuven
StadLeuven
Auteur 2
NaamDELAERE
InitialenL
InstituutAfdeling Oogheelkunde UZLeuven
StadLeuven
Auteur 3
NaamVANINBROUKX
InitialenI
InstituutAfdeling Oogheelkunde UZLeuven
StadLeuven
Auteur 4
NaamVAN CALSTER
InitialenJ
InstituutAfdeling Oogheelkunde UZLeuven
StadLeuven
Auteur 5
NaamSTALMANS
InitialenP
InstituutAfdeling Oogheelkunde UZLeuven
StadLeuven
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