Anti-VEGF drugs can aid in displacement of submacular hemorrhage

KEY BISCAYNE, Fla. — Postoperatively injecting intravitreal ranibizumab or bevacizumab can significantly aid in displacement of large submacular hemorrhages and continued macular flattening, according to a surgeon speaking here.

Allen C. Ho, MD, presented his experience using the anti-vascular endothelial growth factor drugs in patients suffering from submacular hemorrhages at Bascom Palmer Eye Institute's Angiogenesis 2007 meeting.

"When you see this kind of lesion, it does not mean this patient is doomed," said Dr. Ho, referring to a case in which a patient had a large submacular hemorrhage.

For such patients, Dr. Ho performs vitrectomy and injects tissue plasminogen activator into the border of the hemorrhage, allowing it to dissect and causing pneumatic displacement when the patient is placed face down. By combining the procedure with intravitreal Avastin (bevacizumab, Genentech) or Lucentis (ranibizumab, Genentech) postoperatively, Dr. Ho has achieved 3 months of flattening, he said.

"This technique affords the best chance for displacement," he said.