2M.D. Professor, Gazi University Faculty of Medicine, Department of Ophthalmology, Ankara/TURKEY Purpose: To compare the results of intravitreal tissue plasminogen activator (tPA), anti-VEGF and expansile gas injection with intravitreal anti-VEGF therapy alone for limited submacular haemorrhage.
Material and Methods: The medical records of patients who presented with submacular haemorrhage between January 2007 and January 2014 were reviewed. Patients who had acute onset of bleeding (15 days), treated with intravitreal injection of tPA solution, anti-VEGF (50 μg in 0.05 ml) and expansile gas (0.3-0.4 cc of 100% SF6), and followed up at least 6 months, involved in this study as group A. And patients who had acute onset of bleeding (15 days), treated with intravitreal ranibizumab alone and followed up at least 6 months were involved in this study as group B. Mean best-corrected visual acuity (BCVA) post-treatment results and complications of two groups were compared.
Results: A total of 10 eyes of 15 patients were involved in this study. 6 eyes were involved as group A and 4 eyes as group B. The mean duration of hemorrhage was 9.1±5.7 days in group A and 10±2.1 days in group B. The etiology of haemorrhage were age-related macular degeneration (ARMD) in 4 eyes (66.6%), in group A and ARMD in all eyes in group B. There was no statistically significant difference in preoperative mean BCVA between the two groups, however, BCVA results were significantly better in group A after treatment. One patient had rhegmatogenous retinal detachment as a complication of pneumatic displacement.
Conclusion: The treatment of submacular haemorrhage with intravitreal injection of tPA and antİ-VEGF and expansile gas is an encouraging procedure leading to improved visual acuity.
Keywords : Expansile gas, submacular haemorrhage, tissue plasminogen activator