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Published on: September 13, 2016
[Intra-vitreal rt-PA and gas introduction in submacular hemorrhage]
M Buhl1, A Scheider, C L Schönfeld
1Universitäts-Augenklinik München.
Summary
Intravitreal injection of recombinant tissue plasminogen activator (rt-PA) and sulfur hexafluoride gas (SF6) offers a new treatment for submacular hemorrhage, improving vision in some patients with choroidal neovascularization and macroaneurysm.
Area of Science:
- Ophthalmology
- Retinal Diseases
- Vitreoretinal Surgery
Context:
- Submacular hemorrhage (SMH) is a severe complication of various retinal diseases.
- Current treatments for SMH have limitations in efficacy and safety.
- Novel therapeutic approaches are needed to improve visual outcomes in SMH patients.
Purpose:
- To evaluate the efficacy and safety of intravitreal recombinant tissue plasminogen activator (rt-PA) combined with sulfur hexafluoride (SF6) gas for treating submacular hemorrhage.
- To assess visual acuity changes and postoperative complications in patients undergoing this treatment.
Summary:
- This study involved 53 patients (mean age 79 years) with SMH, primarily due to choroidal neovascularization (47 patients) or macroaneurysm (6 patients).
- Patients received intravitreal rt-PA (50 micrograms) and SF6 gas after acetazolamide administration, followed by 24 hours of prone positioning.
- Visual acuity improved by at least two lines in 23 patients with neovascularization and in 5 of 6 patients with macroaneurysm. Deterioration occurred in 12 patients. Complications included four vitreous hemorrhages and one endophthalmitis.
Impact:
- Intravitreal rt-PA and SF6 injection presents a viable alternative treatment option for submacular hemorrhage.
- This method demonstrates potential for visual acuity improvement in specific SMH etiologies.
- Further research is warranted to optimize this technique and manage associated complications.
