Gravitational displacement of submacular haemorrhage in patients with age-related macular disease

Erdoğan, Gürkan; Kirmaci, Asli; Perente, İrfan; Artunay, Özgür

doi:10.1038/s41433-019-0720-8

Cited by 6 publications

(3 citation statements)

References 14 publications

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“…[7][8][9][10][11] A displacement of larger subretinal hemorrhages associated with neovascular AMD can be done by pars plana vitrectomy (PPV) combined with a subretinal injection of tissue plasminogen activator (tPA) and pneumatic displacement with air followed by postoperative intravitreal injection of anti-VEGF agent. 12 In addition, PPV combined with a subretinal injection of tPA and intravitreal anti-VEGF agent without any tamponade, 13 or PPV combined with subretinal injection of tPA and anti-VEGF agent followed by a gas tamponade can be used to treat these eyes. 14 Kimura et al reported that the displacement of subretinal hemorrhage by PPV and subretinal injection of tPA with air tamponade can improve the retinal sensitivity and the best-corrected visual acuity (BCVA).…”

Section: Introductionmentioning

confidence: 99%

Vitrectomy combined with subretinal injection of tissue plasminogen activator for successful treatment of massive subretinal hemorrhage

Saito-Uchida

Inoue

Koto

et al. 2020

European Journal of Ophthalmology

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Purpose: To evaluate the outcome of vitrectomy combined with a subretinal injection of tissue plasminogen activator (tPA) to treat a massive subretinal hemorrhage. Methods: The medical records of 11 eyes of 11 patients (seven men, four women, mean age; 74.5 ± 9.6 years) with a massive (>10 disc area) subretinal hemorrhage were reviewed. The patients were treated with vitrectomy combined with a subretinal injection of tPA with or without external drainage. Results: The mean baseline visual acuity was 2.10 ± 0.45 logarithm of the minimum angle of resolution (logMAR) units. The hemorrhage was externalized in three eyes due to bullous hemorrhagic retinal detachment. The subretinal hemorrhage was displaced away from the fovea in 10 eyes (91%) and reduced in one eye. Retinal reattachment was achieved in all eyes however reoperations were needed in five eyes (45%) among the eight eyes (73%) with recurrent vitreous and/or subretinal hemorrhages. The postoperative vision at 3 months was significantly improved to 1.32 ± 0.65 logMAR units ( p = 0.0076). The vision in the two eyes without postoperative subretinal hyperreflective material at the fovea recovered to 0.4 logMAR units but none of the nine eyes with the foveal subretinal hyperreflective material had vision better than 0.1 logMAR units. Conclusion: Vitrectomy with subretinal injection of tPA with or without external drainage of the subretinal hemorrhage was effective in treating massive subretinal hemorrhages.

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Section: Introductionmentioning

confidence: 99%

Vitrectomy combined with subretinal injection of tissue plasminogen activator for successful treatment of massive subretinal hemorrhage

Saito-Uchida

Inoue

Koto

et al. 2020

European Journal of Ophthalmology

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“…Tissue plasminogen activator (t-PA) combined with or without intravitreal gas injection has been used for SRH [25][26] . The t-PA is injected into the submacular hemorrhage clot to dissolve the submacular hemorrhage clot, and gas is pressed against the submacular blood to the periphery retina through the appropriate body position to reduce the damage to the macular retinal structure and cells by submacular hemorrhage [27][28] .…”

Section: Discussionmentioning

confidence: 99%

Retinal laser photocoagulation and intravitreal injection of anti-VEGF for hemorrhagic retinal arterial microaneurysm

Huang,

Li,

Sun

et al. 2023

Int J Ophthalmol

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AIM: To evaluate the efficacy of retinal laser photocoagulation and intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) for hemorrhagic retinal arterial macroaneurysm (RAM). METHODS: This was a retrospective clinical study. Patients with hemorrhagic RAM were divided into 4 groups defined by different treatments: a retinal laser photocoagulation therapy monotherapy group, an anti-VEGF intravitreal injection monotherapy group, a laser and anti-VEGF combination therapy group, and an observation group. Visual acuity (VA), central macular thickness (CMT), and retinal hemorrhage area (RHA) were collected. RESULTS: Forty-seven eyes of 47 patients were enrolled. VA improved and had a significant difference between baseline and final in each treatment group (logMAR; laser group: 1.90±0.53 vs 1.05±0.63, P<0.001; anti-VEGF group: 1.75±0.63 vs 1.12±0.54, P=0.009; combination group: 1.76±0.38 vs 1.01±0.52, P<0.001); however, VA decreased and had no significant difference in observation group (1.63±0.51 vs 1.76±0.61, P=0.660). CMT decreased and had a significant difference between baseline and final in each group (laser group: 815.16±310.83 vs 252.05±83.90 μm, P<0.001; anti-VEGF group: 725.00±290.79 vs 203.56±69.89 μm, P=0.001; combination group: 595.50±186.51 vs 253.13±55.06 μm, P=0.001; observation group: 758.88±195.65 vs 267.00±120.90 μm, P=0.001). RHA were 28.99±28.15, 25.94±11.58, 19.64±8.97, and 27.45±13.76 mm2 in laser group, anti-VEGF group, combination group and observation group, respectively. RHA was statistically correlated with final VA (P=0.032) in the observation group. CONCLUSION: Both laser and anti-VEGF treatments are effective for hemorrhagic RAM. Combination therapy reduces the number of injections of anti-VEGF. RHA is a visual prognosis predictor in the natural history of hemorrhagic RAM.

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“…In this issue Erdogan et al [1] describe an original approach to submacular haemorrhage (SMH) displacement. They simply create a subretinal fluid area bathing the submacular blood clot in tissue plasminogen activator (TPA), without the use of any gas.…”

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confidence: 99%

Many ways to displace a blood clot. But do we need to do so?

Meurs

2019

Eye

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Gravitational displacement of submacular haemorrhage in patients with age-related macular disease

Cited by 6 publications

References 14 publications

Vitrectomy combined with subretinal injection of tissue plasminogen activator for successful treatment of massive subretinal hemorrhage

Vitrectomy combined with subretinal injection of tissue plasminogen activator for successful treatment of massive subretinal hemorrhage

Retinal laser photocoagulation and intravitreal injection of anti-VEGF for hemorrhagic retinal arterial microaneurysm

Many ways to displace a blood clot. But do we need to do so?

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