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Retina Arter Tıkanıklıkları ve Tedavisi...
Santral Retinal Ven Tıkanıklığı Güncel Tedavisi...
Central Retinal Artery Occlusion As the Cause of Unilateral Concentric Narrowing of Visual Field and Presence of Cilioretinal Artery...
Bilateral Optic Disc Drusen
Vascular Endothelial Growth Factor and Anti VEGF Agents...
Central Retinal Artery Occlusion As the Cause of Unilateral Concentric Narrowing of Visual Field and Presence of Cilioretinal Artery...
Retina Arter Tıkanıklıkları ve Tedavisi...
Morning Glory Syndrome Associated with Retinochoroidal Coloboma...
Santral Retinal Ven Tıkanıklığı Güncel Tedavisi...
Bilateral Optic Disc Drusen
PureSee Kesintisiz Yüksek Kalitede Görüş
Retina-Vitreous 2024 , Vol 33 , Num 3
Turkish Abstract Abstract Free Full Text English Similar Articles Mail to Author
Integrated therapies for neovascular age-related macular degeneration related submacular hemorrhages: vitrectomy, tPA, and bevacizumab synergy
Serhat Ermis1, Ece Ozal1, Murat Karapapak1, Emre Avci1, Hakan Baybora1, Yusuf Cem Yilmaz1, Serife Ciloglu Hayat1, Sadik Altan Ozal1
Department of Ophthalmology, Başakşehir Çam and Sakura City Hospital, İstanbul, Türkiye DOI : 10.37845/ret.vit.2024.33.31 Purpose: To evaluate the functional and structural outcomes of a combination of vitrectomy, gas tamponade, subretinal tissue plasminogen activator (tPA) and intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection in patients with submacular hemorrhage (SMH) secondary to neovascular age-related macular degeneration (nAMD) and to investigate preoperative prognostic factors.

Materials and Methods: This retrospective study involved 24 eyes from 24 patients (15 males, 9 females). We assessed preoperative SMH duration, thickness, and area, along with the hemorrhage displacement ratio total or subtotal subretinal hemorrhage within 1500 ?m centered on the fovea post-vitrectomy. At the 12-month visit BCVA, lens status, preoperative intravitreal anti-VEGF injection count, and concurrent medical conditions were also documented.

Results: The patients had a mean age of 73.3 ± 8.2 years. The average BCVA significantly improved from a baseline logMAR of 2.0 ± 0.4 to logMAR 1.3 ± 0.6 at 12-month visit (p<0.001). Throughout follow-up, both SMH area and thickness showed statistically significant decreases (p<0.001). In the total displacement group, baseline BCVA was better, and values were maintained or even improved during follow-up. Correlation analysis revealed a strong positive relationship between BCVA at the 12-month visit, baseline BCVA, and SMH duration. (p=0.009, p=0.008)

Conclusıon: Vitrectomy, submacular tPA, anti-VEGF injection, and SF6 tamponade are safe and effective procedures in patients with nAMD secondary to SMH. The timing of surgery and the initial level of BCVA are the most critical factors determining the 12-month visit BCVA outcome. Keywords : Submacular hemorrhage, tissue plasminogen activator, age-related macular degeneration, anti-VEGF

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