Subretinal Tissue Plasminogen Activator Injection Using a Nanovitreoretinal Device for Massive Submacular Hemorrhage:...

Area of Science:

• Ophthalmology
• Retinal Diseases
• Vitreoretinal Surgery

Background:

• Massive submacular hemorrhage (SMH) poses a significant challenge in retinal disease management.
• Current treatment options for SMH have limitations, necessitating novel therapeutic approaches.

Purpose of the Study:

• To evaluate the efficacy of subretinal tissue plasminogen activator (tPA) injection using a nanovitreoretinal (NVR) device in patients with massive SMH.
• To compare outcomes between patients treated with and without vitrectomy.

Main Methods:

• Retrospective study of 18 eyes with massive SMH treated with subretinal tPA injection (12.5 μg/0.1 mL) via an NVR device.
• Primary outcomes included changes in best-corrected visual acuity (BCVA) and central macular thickness (CMT).
• Secondary outcomes assessed SMH thickness reduction and compared surgical approaches (vitrectomy vs. non-vitrectomy).

Main Results:

• Significant improvements in BCVA (P=0.01) and CMT (P=0.019) were observed post-injection.
• Mean BCVA improved from 1.79 to 1.28 logMAR, with 55.6% achieving ≥3-line improvement.
• Significant reduction in SMH thickness (P=0.02) and CMT (81.3% achieved ≥20% reduction) were noted.
• No significant differences in final BCVA or CMT reduction were found between vitrectomy and non-vitrectomy groups (P>0.850).

Conclusions:

• Subretinal tPA injection via the NVR device is effective for improving visual and anatomical outcomes in massive SMH.
• The non-vitrectomy approach demonstrated comparable results to vitrectomy, though further research with larger sample sizes is warranted.