VITRECTOMY WITH SUBRETINAL TENECTEPLASE AND INTRAVITREAL CONBERCEPT FOR SUBMACULAR HEMORRHAGE: A Prospective...

Area of Science:

• Ophthalmology
• Retinal Surgery
• Vitreoretinal Interface Disorders

Background:

• Submacular hemorrhage (SMH) poses a significant challenge to vision.
• Current treatments for SMH have limitations in efficacy and safety.
• Novel surgical techniques are needed to improve outcomes for SMH patients.

Purpose of the Study:

• To introduce and evaluate a novel vitrectomy technique for submacular hemorrhage (SMH).
• The technique combines subretinal tenecteplase (TNK-tPA) injection, intravitreal conbercept, and C3F8 gas tamponade.
• To assess the efficacy and safety of this combined approach for SMH treatment.

Main Methods:

• A single-center, prospective, interventional study involving 20 patients with treatment-naïve spontaneous SMH.
• Patients underwent 25-gauge vitrectomy with subretinal TNK-tPA and intravitreal conbercept injection.
• Post-operative assessment included best-corrected visual acuity (BCVA) and central retinal thickness (CRT) at multiple time points.

Main Results:

• Significant reduction in central retinal thickness (CRT) from baseline (887.1±52.2μm) to 6 months post-operatively (276.7±83.8μm; P < 0.001).
• 75% of patients achieved a favorable visual outcome (BCVA ≤0.5 log MAR) at 6 months.
• The SMH onset-vitrectomy interval (SOVI) was a significant predictor of visual outcomes, with shorter intervals correlating to better results.

Conclusions:

• The described vitrectomy technique, incorporating subretinal TNK-tPA, intravitreal conbercept, and C3F8 gas, shows promise for treating spontaneous SMH.
• Early intervention (within 30 days of onset) is crucial for achieving optimal visual improvement.
• This combined approach offers a potential new therapeutic option for SMH management.