Displacement of submacular hemorrhage associated with age-related macular degeneration using vitrectomy and submacular tPA injection followed by intravitreal ranibizumab

Sukhpal Singh Sandhu1,2, Sridhar Manvikar1, David Henry William Steel11Sunderland Eye Infirmary, Sunderland, United Kingdom; 2Centre for Eye Research Australia, Melbourne, AustraliaBackground/aims: To evaluate retrospectively the clinical outcomes of patients presenting with submacular hemorrhage (S...

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Autores principales:	Sukhpal Singh Sandhu, Sridhar Manvikar, David Henry William Steel
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2010
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/b9af66fadac34d249eed5524dbc28ff3
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spelling	oai:doaj.org-article:b9af66fadac34d249eed5524dbc28ff32021-12-02T05:48:23ZDisplacement of submacular hemorrhage associated with age-related macular degeneration using vitrectomy and submacular tPA injection followed by intravitreal ranibizumab1177-54671177-5483https://doaj.org/article/b9af66fadac34d249eed5524dbc28ff32010-06-01T00:00:00Zhttp://www.dovepress.com/displacement-of-submacular-hemorrhage-associated-with-age-related-macu-a4634https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Sukhpal Singh Sandhu1,2, Sridhar Manvikar1, David Henry William Steel11Sunderland Eye Infirmary, Sunderland, United Kingdom; 2Centre for Eye Research Australia, Melbourne, AustraliaBackground/aims: To evaluate retrospectively the clinical outcomes of patients presenting with submacular hemorrhage (SMH) secondary to neovascular age-related macular degeneration (nAMD), treated by vitrectomy, submacular tissue plasminogen activator (tPA) injection and pneumatic displacement of SMH with air followed by postoperative intravitreal ranibizumab (RZB).Methods: Patients with SMH and nAMD had 25-guage vitrectomy and subretinal tPA (12.5 micrograms/0.1 mL) with fluid/air exchange. Intravitreal RZB was administered postoperatively to patients eligible for National Health Service (NHS) funded treatment.Results: Of the total of 16 patients, 11 (68.7%) had complete displacement of SMH. The remaining five had residual SMH, mainly subretinal pigment epithelium in location. Three of the four patients who previously had a failed expansile gas pneumatic displacement were successfully displaced with vitrectomy surgery. At presentation 5/16 (31.3%) patients were eligible for NHS funded intravitreal RZB. This increased to 12 patients after the vitrectomy procedure (75.0%). At 6 months postoperatively all improved by $1 line. Ten of the 16 patients (63%) improved by &ge;2 lines, with 10 of the 12 patients (83%) treated with RZB improving by &ge;2 lines.Conclusion: Vitrectomy/subretinal tPA/air to displace SMH followed by intravitreal RZB injection can stabilize/improve vision in patients with nAMD. This technique displaces hemorrhage not displaced by attempted expansile gas techniques.Keywords: submacular hemorrhage, neovascular age-related macular degeneration, vitrectomy, tissue plasminogen activator, ranibizumab Sukhpal Singh SandhuSridhar ManvikarDavid Henry William SteelDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2010, Iss default, Pp 637-642 (2010)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Sukhpal Singh Sandhu Sridhar Manvikar David Henry William Steel Displacement of submacular hemorrhage associated with age-related macular degeneration using vitrectomy and submacular tPA injection followed by intravitreal ranibizumab
description	Sukhpal Singh Sandhu1,2, Sridhar Manvikar1, David Henry William Steel11Sunderland Eye Infirmary, Sunderland, United Kingdom; 2Centre for Eye Research Australia, Melbourne, AustraliaBackground/aims: To evaluate retrospectively the clinical outcomes of patients presenting with submacular hemorrhage (SMH) secondary to neovascular age-related macular degeneration (nAMD), treated by vitrectomy, submacular tissue plasminogen activator (tPA) injection and pneumatic displacement of SMH with air followed by postoperative intravitreal ranibizumab (RZB).Methods: Patients with SMH and nAMD had 25-guage vitrectomy and subretinal tPA (12.5 micrograms/0.1 mL) with fluid/air exchange. Intravitreal RZB was administered postoperatively to patients eligible for National Health Service (NHS) funded treatment.Results: Of the total of 16 patients, 11 (68.7%) had complete displacement of SMH. The remaining five had residual SMH, mainly subretinal pigment epithelium in location. Three of the four patients who previously had a failed expansile gas pneumatic displacement were successfully displaced with vitrectomy surgery. At presentation 5/16 (31.3%) patients were eligible for NHS funded intravitreal RZB. This increased to 12 patients after the vitrectomy procedure (75.0%). At 6 months postoperatively all improved by $1 line. Ten of the 16 patients (63%) improved by &ge;2 lines, with 10 of the 12 patients (83%) treated with RZB improving by &ge;2 lines.Conclusion: Vitrectomy/subretinal tPA/air to displace SMH followed by intravitreal RZB injection can stabilize/improve vision in patients with nAMD. This technique displaces hemorrhage not displaced by attempted expansile gas techniques.Keywords: submacular hemorrhage, neovascular age-related macular degeneration, vitrectomy, tissue plasminogen activator, ranibizumab
format	article
author	Sukhpal Singh Sandhu Sridhar Manvikar David Henry William Steel
author_facet	Sukhpal Singh Sandhu Sridhar Manvikar David Henry William Steel
author_sort	Sukhpal Singh Sandhu
title	Displacement of submacular hemorrhage associated with age-related macular degeneration using vitrectomy and submacular tPA injection followed by intravitreal ranibizumab
title_short	Displacement of submacular hemorrhage associated with age-related macular degeneration using vitrectomy and submacular tPA injection followed by intravitreal ranibizumab
title_full	Displacement of submacular hemorrhage associated with age-related macular degeneration using vitrectomy and submacular tPA injection followed by intravitreal ranibizumab
title_fullStr	Displacement of submacular hemorrhage associated with age-related macular degeneration using vitrectomy and submacular tPA injection followed by intravitreal ranibizumab
title_full_unstemmed	Displacement of submacular hemorrhage associated with age-related macular degeneration using vitrectomy and submacular tPA injection followed by intravitreal ranibizumab
title_sort	displacement of submacular hemorrhage associated with age-related macular degeneration using vitrectomy and submacular tpa injection followed by intravitreal ranibizumab
publisher	Dove Medical Press
publishDate	2010
url	https://doaj.org/article/b9af66fadac34d249eed5524dbc28ff3
work_keys_str_mv	AT sukhpalsinghsandhu displacementofsubmacularhemorrhageassociatedwithagerelatedmaculardegenerationusingvitrectomyandsubmaculartpainjectionfollowedbyintravitrealranibizumab AT sridharmanvikar displacementofsubmacularhemorrhageassociatedwithagerelatedmaculardegenerationusingvitrectomyandsubmaculartpainjectionfollowedbyintravitrealranibizumab AT davidhenrywilliamsteel displacementofsubmacularhemorrhageassociatedwithagerelatedmaculardegenerationusingvitrectomyandsubmaculartpainjectionfollowedbyintravitrealranibizumab
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Displacement of submacular hemorrhage associated with age-related macular degeneration using vitrectomy and submacular tPA injection followed by intravitreal ranibizumab

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