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Good results seen with air injection, tissue plasminogen activator in eyes with submacular hemorrhages due to AMD
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Subretinal air injection with tissue plasminogen activator and postoperative positioning may improve the outcome of massive submacular hemorrhages secondary to age-related macular degeneration, according to a study.
The prospective, interventional case series included 13 eyes of 13 consecutive patients with massive submacular hemorrhages with a 3-month follow-up after the procedure.
After vitrectomy, pneumatic displacement involved a submacular injection of 0.4 mL of tissue plasminogen activator and 0.4 mL of filtered air using a microneedle. The patient stayed in the prone position overnight so that the air pressure would displace the hemorrhage.
All eyes achieved total subfoveal blood displacement.
One month postoperatively, visual acuity improved by more than two lines in 11 eyes, was unchanged in one eye and worsened in one eye. Three months postoperatively, visual acuity improved by more than five lines in 11 eyes and decreased by more than two lines in one eye.
Mean visual acuity in all eyes improved from 20/300 at baseline to 20/130 at 1 month after surgery and 20/100 at 3 months.
Mean OCT central lesion thickness decreased from 796 µm at baseline to 361 µm at 3 months postoperatively (P = .0003).
Surgical complications included intraoperative macular hole formation in one eye and vitreous hemorrhages in one eye. – by Kristie L. Kahl
Disclosure: The authors report no relevant financial disclosures.
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