Vitrectomy with subretinal tissue plasminogen activator for submacular haemorrhages secondary to age-related macular degeneration: retrospective case series of 45 consecutive cases.
Vitrectomy with subretinal tissue plasminogen activator for submacular haemorrhages secondary to age-related macular degeneration: retrospective case series of 45 consecutive cases.
González-López JJ, McGowan G, Chapman E, Yorston D. Eye (Lond). 2016 Jul;30(7):929-35. doi: 10.1038/eye.2016.65. Epub 2016 Apr 8.PMID: 27055681 Free PMC article.
Abstract
Background:PurposeTo assess the efficacy of small-gauge vitrectomy with subretinal recombinant tissue plasminogen activator (rtPA) for submacular haemorrhages secondary to neovascular age-related macular degeneration (nAMD), and to identify the factors associated with visual outcome.MethodsA retrospective case series was performed, including all patients who had small-gauge vitrectomy with subretinal rtPA for submacular haemorrhages secondary to nAMD. All patients received three consecutive monthly injections after the surgery, and were reviewed monthly and treated on a pro re nata regime.ResultsA 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
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