Transconjunctival sutureless vitrectomy with tissue plasminogen activator, gas and intravitreal bevacizumab in the management of predominantly hemorrhagic age-related macular degeneration

Luis Arias1,2, Jordi Mon&eacute;s11Institut de la M&agrave;cula i de la Retina, Centro M&eacute;dico Teknon, Barcelona; 2Hospital Universitari de Bellvitge, L&rsquo;Hospitalet de Llobregat, BarcelonaPurpose: To determine the efficacy and safety of treating predominant...

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Autores principales:	Luis Arias, Jordi Mon&eacute;s
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2010
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/b7d3fceb56d244fea27dc88ec79a3637
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spelling	oai:doaj.org-article:b7d3fceb56d244fea27dc88ec79a36372021-12-02T06:53:49ZTransconjunctival sutureless vitrectomy with tissue plasminogen activator, gas and intravitreal bevacizumab in the management of predominantly hemorrhagic age-related macular degeneration1177-54671177-5483https://doaj.org/article/b7d3fceb56d244fea27dc88ec79a36372010-02-01T00:00:00Zhttp://www.dovepress.com/transconjunctival-sutureless-vitrectomy-with-tissue-plasminogen-activa-a3949https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Luis Arias1,2, Jordi Mon&eacute;s11Institut de la M&agrave;cula i de la Retina, Centro M&eacute;dico Teknon, Barcelona; 2Hospital Universitari de Bellvitge, L&rsquo;Hospitalet de Llobregat, BarcelonaPurpose: To determine the efficacy and safety of treating predominantly hemorrhagic age-related macular degeneration (AMD) with transconjunctival sutureless vitrectomy (TSV), tissue plasminogen activator (tPA), sulphur hexafluoride (SF6), and intravitreal bevacizumab.Methods: Retrospective study, consecutive case series. Patients with acute hemorrhagic AMD treated with 25- or 23-gauge TSV, subretinal or intravitreal tPA, fluid-air-SF6 exchange and intravitreal injection of bevacizumab. All operations were performed within the first 5 days after the start of symptoms, which consisted of visual acuity (VA) loss and central scotoma.Results: Fifteen eyes from 15 patients were included. The patients&rsquo; mean age was 79.6 years, and the mean follow-up was 11.8 months. Five patients (33%) were receiving oral anticoagulant treatment. At baseline, the mean VA (logMAR values) was 1.5 (20/640 Snellen equivalent). At the last follow-up visit, the mean VA was 1.1 (20/250) (P &lt; 0.0001; paired t-test). The submacular hemorrhage was successfully displaced in all the cases. Complications consisted of three cases of vitreous hemorrhage and a tear or the retinal pigment epithelium. Twelve cases (80%) did not require further treatment during the follow-up period.Conclusion: A surgical approach with 25- or 23-gauge TSV, tPA, SF6 and intravitreal bevacizumab is an efficacious and safe procedure in patients with hemorrhagic AMD. Early treatment is advisable for obtaining the optimal outcome.Keywords: Hemorrhagic age-related macular degeneration, tissue plasminogen activator, intravitreal bevacizumab; transconjunctival sutureless vitrectomy Luis AriasJordi Mon&eacute;sDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2010, Iss default, Pp 67-72 (2010)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Luis Arias Jordi Mon&eacute;s Transconjunctival sutureless vitrectomy with tissue plasminogen activator, gas and intravitreal bevacizumab in the management of predominantly hemorrhagic age-related macular degeneration
description	Luis Arias1,2, Jordi Mon&eacute;s11Institut de la M&agrave;cula i de la Retina, Centro M&eacute;dico Teknon, Barcelona; 2Hospital Universitari de Bellvitge, L&rsquo;Hospitalet de Llobregat, BarcelonaPurpose: To determine the efficacy and safety of treating predominantly hemorrhagic age-related macular degeneration (AMD) with transconjunctival sutureless vitrectomy (TSV), tissue plasminogen activator (tPA), sulphur hexafluoride (SF6), and intravitreal bevacizumab.Methods: Retrospective study, consecutive case series. Patients with acute hemorrhagic AMD treated with 25- or 23-gauge TSV, subretinal or intravitreal tPA, fluid-air-SF6 exchange and intravitreal injection of bevacizumab. All operations were performed within the first 5 days after the start of symptoms, which consisted of visual acuity (VA) loss and central scotoma.Results: Fifteen eyes from 15 patients were included. The patients&rsquo; mean age was 79.6 years, and the mean follow-up was 11.8 months. Five patients (33%) were receiving oral anticoagulant treatment. At baseline, the mean VA (logMAR values) was 1.5 (20/640 Snellen equivalent). At the last follow-up visit, the mean VA was 1.1 (20/250) (P &lt; 0.0001; paired t-test). The submacular hemorrhage was successfully displaced in all the cases. Complications consisted of three cases of vitreous hemorrhage and a tear or the retinal pigment epithelium. Twelve cases (80%) did not require further treatment during the follow-up period.Conclusion: A surgical approach with 25- or 23-gauge TSV, tPA, SF6 and intravitreal bevacizumab is an efficacious and safe procedure in patients with hemorrhagic AMD. Early treatment is advisable for obtaining the optimal outcome.Keywords: Hemorrhagic age-related macular degeneration, tissue plasminogen activator, intravitreal bevacizumab; transconjunctival sutureless vitrectomy
format	article
author	Luis Arias Jordi Mon&eacute;s
author_facet	Luis Arias Jordi Mon&eacute;s
author_sort	Luis Arias
title	Transconjunctival sutureless vitrectomy with tissue plasminogen activator, gas and intravitreal bevacizumab in the management of predominantly hemorrhagic age-related macular degeneration
title_short	Transconjunctival sutureless vitrectomy with tissue plasminogen activator, gas and intravitreal bevacizumab in the management of predominantly hemorrhagic age-related macular degeneration
title_full	Transconjunctival sutureless vitrectomy with tissue plasminogen activator, gas and intravitreal bevacizumab in the management of predominantly hemorrhagic age-related macular degeneration
title_fullStr	Transconjunctival sutureless vitrectomy with tissue plasminogen activator, gas and intravitreal bevacizumab in the management of predominantly hemorrhagic age-related macular degeneration
title_full_unstemmed	Transconjunctival sutureless vitrectomy with tissue plasminogen activator, gas and intravitreal bevacizumab in the management of predominantly hemorrhagic age-related macular degeneration
title_sort	transconjunctival sutureless vitrectomy with tissue plasminogen activator, gas and intravitreal bevacizumab in the management of predominantly hemorrhagic age-related macular degeneration
publisher	Dove Medical Press
publishDate	2010
url	https://doaj.org/article/b7d3fceb56d244fea27dc88ec79a3637
work_keys_str_mv	AT luisarias transconjunctivalsuturelessvitrectomywithtissueplasminogenactivatorgasandintravitrealbevacizumabinthemanagementofpredominantlyhemorrhagicagerelatedmaculardegeneration AT jordimonampeacutes transconjunctivalsuturelessvitrectomywithtissueplasminogenactivatorgasandintravitrealbevacizumabinthemanagementofpredominantlyhemorrhagicagerelatedmaculardegeneration
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Transconjunctival sutureless vitrectomy with tissue plasminogen activator, gas and intravitreal bevacizumab in the management of predominantly hemorrhagic age-related macular degeneration

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