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Posters

Comparative of subretinal injection of tissue plasminogen activator and pneumatic displacement in the treatment of thick submacular hemorrhage

Poster Details

First Author: S.Sukavatcharin THAILAND

Co Author(s):    N. Tranti   W. Prasartritta   R.C. Olarn            0   0 0   0 0   0 0   0 0

Abstract Details



Purpose:

To compare outcome of subretinal injection of tissue plasminogen activator (tPA) combined with intravitreal bevazicumab injection in the treatment of thick submacular hemorrhage

Setting:

Ramathibodi Hospitial, Mahidol University, Bangkok, Thailand

Methods:

Retrospective comparative case study of 40 eyes of 40 patients presenting with thick submacular hemorrhage from Aged-related macula degeneration (AMD) or Idiopathic polypoidal choroidal vasculopathy (IPCV). Group 1 (20 patients) were treated with pars plana vitrectomy, subretinal injection of tPA (25-50 µg), intravitreal bevazicumab (1.25mg/0.05 ml) injection and partial fluid-air(or fluid-gas) exchange followed by 1-day face-down or upright positioning. Group 2 (20 patients) were treated with pneumatic retinopexy with perfluoropropane gas with or without tPA/anti-VEGF intravitreal injection. Patient demographics, diagnosis, visual acuity, duration of follow up, displacement of hemorrhage from the fovea, and any late post operative complication were obtained.

Results:

There were F:M 7:13 in group 1 and 9:11 in group 2. The preoperative BCVA ranged from HM-20/50 (mean = 20/400) in both group. Postoperatively, submacular hemorrhage was totally displaced from fovea in 80% of the patients in group 1 and none in group 2 at 1 month with statistic significant. Best postoperative visual acuity at 6 months varied from CF to 20/20 (median =20/50), with improvement noted in 17 cases (85%) in group 1 and VA ranged from HM to 20/30 (median = 20/100) with VA improvement in 50% in group 2. BCVA of > 20/40 was achieved in 8 patients (40%) in group 1 while 2 patients (10%) in group 2. Mean postoperative follow-up was 1.1 year (range, 2 months to 2.6 years) in both groups.

Conclusions:

These results showed that subretinal injection of tPA combined with intravitreal bevazicumab injection have favorable subretinal blood displacement and faster visual improvement if compare to pneumatic displacement method.

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