Displacement of submacular hemorrhage associated with age-related macular degeneration using vitrectomy and submacular tPA injection followed by intravitreal ranibizumab
Sukhpal Singh Sandhu1,2, Sridhar Manvikar1, David Henry William Steel11Sunderland Eye Infirmary, Sunderland, United Kingdom; 2Centre for Eye Research Australia, Melbourne, AustraliaBackground/aims: To evaluate retrospectively the clinical outcomes of patients presenting with submacular hemorrhage (S...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2010-06-01
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| Series: | Clinical Ophthalmology |
| Online Access: | http://www.dovepress.com/displacement-of-submacular-hemorrhage-associated-with-age-related-macu-a4634 |
| _version_ | 1819005861545115648 |
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| author | Sukhpal Singh Sandhu Sridhar Manvikar David Henry William Steel |
| author_facet | Sukhpal Singh Sandhu Sridhar Manvikar David Henry William Steel |
| author_sort | Sukhpal Singh Sandhu |
| collection | DOAJ |
| description | Sukhpal Singh Sandhu1,2, Sridhar Manvikar1, David Henry William Steel11Sunderland Eye Infirmary, Sunderland, United Kingdom; 2Centre for Eye Research Australia, Melbourne, AustraliaBackground/aims: To evaluate retrospectively the clinical outcomes of patients presenting with submacular hemorrhage (SMH) secondary to neovascular age-related macular degeneration (nAMD), treated by vitrectomy, submacular tissue plasminogen activator (tPA) injection and pneumatic displacement of SMH with air followed by postoperative intravitreal ranibizumab (RZB).Methods: Patients with SMH and nAMD had 25-guage vitrectomy and subretinal tPA (12.5 micrograms/0.1 mL) with fluid/air exchange. Intravitreal RZB was administered postoperatively to patients eligible for National Health Service (NHS) funded treatment.Results: Of the total of 16 patients, 11 (68.7%) had complete displacement of SMH. The remaining five had residual SMH, mainly subretinal pigment epithelium in location. Three of the four patients who previously had a failed expansile gas pneumatic displacement were successfully displaced with vitrectomy surgery. At presentation 5/16 (31.3%) patients were eligible for NHS funded intravitreal RZB. This increased to 12 patients after the vitrectomy procedure (75.0%). At 6 months postoperatively all improved by $1 line. Ten of the 16 patients (63%) improved by ≥2 lines, with 10 of the 12 patients (83%) treated with RZB improving by ≥2 lines.Conclusion: Vitrectomy/subretinal tPA/air to displace SMH followed by intravitreal RZB injection can stabilize/improve vision in patients with nAMD. This technique displaces hemorrhage not displaced by attempted expansile gas techniques.Keywords: submacular hemorrhage, neovascular age-related macular degeneration, vitrectomy, tissue plasminogen activator, ranibizumab |
| first_indexed | 2024-12-20T23:59:31Z |
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| id | doaj.art-b9af66fadac34d249eed5524dbc28ff3 |
| institution | Directory Open Access Journal |
| issn | 1177-5467 1177-5483 |
| language | English |
| last_indexed | 2024-12-20T23:59:31Z |
| publishDate | 2010-06-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Clinical Ophthalmology |
| spelling | doaj.art-b9af66fadac34d249eed5524dbc28ff32022-12-21T19:22:40ZengDove Medical PressClinical Ophthalmology1177-54671177-54832010-06-012010default637642Displacement of submacular hemorrhage associated with age-related macular degeneration using vitrectomy and submacular tPA injection followed by intravitreal ranibizumabSukhpal Singh SandhuSridhar ManvikarDavid Henry William SteelSukhpal Singh Sandhu1,2, Sridhar Manvikar1, David Henry William Steel11Sunderland Eye Infirmary, Sunderland, United Kingdom; 2Centre for Eye Research Australia, Melbourne, AustraliaBackground/aims: To evaluate retrospectively the clinical outcomes of patients presenting with submacular hemorrhage (SMH) secondary to neovascular age-related macular degeneration (nAMD), treated by vitrectomy, submacular tissue plasminogen activator (tPA) injection and pneumatic displacement of SMH with air followed by postoperative intravitreal ranibizumab (RZB).Methods: Patients with SMH and nAMD had 25-guage vitrectomy and subretinal tPA (12.5 micrograms/0.1 mL) with fluid/air exchange. Intravitreal RZB was administered postoperatively to patients eligible for National Health Service (NHS) funded treatment.Results: Of the total of 16 patients, 11 (68.7%) had complete displacement of SMH. The remaining five had residual SMH, mainly subretinal pigment epithelium in location. Three of the four patients who previously had a failed expansile gas pneumatic displacement were successfully displaced with vitrectomy surgery. At presentation 5/16 (31.3%) patients were eligible for NHS funded intravitreal RZB. This increased to 12 patients after the vitrectomy procedure (75.0%). At 6 months postoperatively all improved by $1 line. Ten of the 16 patients (63%) improved by ≥2 lines, with 10 of the 12 patients (83%) treated with RZB improving by ≥2 lines.Conclusion: Vitrectomy/subretinal tPA/air to displace SMH followed by intravitreal RZB injection can stabilize/improve vision in patients with nAMD. This technique displaces hemorrhage not displaced by attempted expansile gas techniques.Keywords: submacular hemorrhage, neovascular age-related macular degeneration, vitrectomy, tissue plasminogen activator, ranibizumabhttp://www.dovepress.com/displacement-of-submacular-hemorrhage-associated-with-age-related-macu-a4634 |
| spellingShingle | Sukhpal Singh Sandhu Sridhar Manvikar David Henry William Steel Displacement of submacular hemorrhage associated with age-related macular degeneration using vitrectomy and submacular tPA injection followed by intravitreal ranibizumab Clinical Ophthalmology |
| title | Displacement of submacular hemorrhage associated with age-related macular degeneration using vitrectomy and submacular tPA injection followed by intravitreal ranibizumab |
| title_full | Displacement of submacular hemorrhage associated with age-related macular degeneration using vitrectomy and submacular tPA injection followed by intravitreal ranibizumab |
| title_fullStr | Displacement of submacular hemorrhage associated with age-related macular degeneration using vitrectomy and submacular tPA injection followed by intravitreal ranibizumab |
| title_full_unstemmed | Displacement of submacular hemorrhage associated with age-related macular degeneration using vitrectomy and submacular tPA injection followed by intravitreal ranibizumab |
| title_short | Displacement of submacular hemorrhage associated with age-related macular degeneration using vitrectomy and submacular tPA injection followed by intravitreal ranibizumab |
| title_sort | displacement of submacular hemorrhage associated with age related macular degeneration using vitrectomy and submacular tpa injection followed by intravitreal ranibizumab |
| url | http://www.dovepress.com/displacement-of-submacular-hemorrhage-associated-with-age-related-macu-a4634 |
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