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Vitrectomy with subretinal tissue plasminogen activator and ranibizumab for submacular haemorrhages secondary to age-related macular degeneration: retrospective case series of 45 consecutive cases
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Vitrectomy with subretinal tissue plasminogen activator and ranibizumab for submacular haemorrhages secondary to age-related macular degeneration: retrospective case series of 45 consecutive cases
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Vitrectomy with subretinal tissue plasminogen activator and ranibizumab for submacular haemorrhages secondary to age-related macular degeneration: retrospective case series of 45 consecutive cases
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Journal Article
Vitrectomy with subretinal tissue plasminogen activator and ranibizumab for submacular haemorrhages secondary to age-related macular degeneration: retrospective case series of 45 consecutive cases
2016
Overview
Purpose
To assess the efficacy of small-gauge vitrectomy with subretinal recombinant tissue plasminogen activator (rtPA) and ranibizumab for submacular haemorrhages secondary to neovascular age-related macular degeneration (nAMD), and to identify the factors associated with visual outcome.
Methods
A retrospective case series was performed, including all patients who had small-gauge vitrectomy with subretinal rtPA and ranibizumab for submacular haemorrhages secondary to nAMD. All patients received three consecutive monthly injections of ranibizumab after the surgery, and were reviewed monthly and treated on a
pro re nata
regime.
Results
A total of 45 eyes of 45 patients were included in the study. Mean age was 77.07±9.67 years, and 32 of 45 patients (71.1%) were women. Surgery was performed on average 6.98±5.70 days after the onset of symptoms, and patients were observed for a follow-up period of 12.9±10.8 months. On average, visual acuity improved −0.59±0.61 LogMAR between presentation and last follow-up. Visual acuity improved in 33 patients (73.3%), remained unchanged in 10 patients (22.2%), and worsened in 2 patients (4.4%). Multiple linear regression showed that patients with smaller haemorrhages (
P
=0.012) and prompt surgery (
P
=0.008) had better final visual acuities. A haemorrhage area of ≤30 mm
2
had 91.3% sensitivity and 73.3% specificity for predicting a final visual acuity ≥6/60.
Conclusion
Small-gauge vitrectomy with subretinal rtPA and ranibizumab is effective for improving visual acuity in patients with submacular haemorrhages secondary to nAMD. Small haemorrhage area and prompt surgery are associated with better final visual acuity.
Publisher
Nature Publishing Group UK,Nature Publishing Group
Subject
/ Aged
/ Angiogenesis Inhibitors - therapeutic use
/ Female
/ Fibrinolytic Agents - therapeutic use
/ Humans
/ Male
/ Medicine
/ Pharmaceutical Sciences/Technology
/ Ranibizumab - therapeutic use
/ Retinal Hemorrhage - drug therapy
/ Retinal Hemorrhage - etiology
/ Surgery
/ Tissue Plasminogen Activator - therapeutic use
/ Tomography, Optical Coherence
/ Vascular Endothelial Growth Factor A - antagonists & inhibitors
