Submacular hemorrhage in polypoidal choroidal vasculopathy treated by vitrectomy and subretinal tissue plasminogen activator

Shuhei Kimura, Yuki Morizane, Mio Hosokawa, Yusuke Shiode, Tetsuhiro Kawata, Shinichiro Doi, Ryo Matoba, Mika Hosogi, Atsushi Fujiwara, Yasushi Inoue, Fumio Shiraga

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Abstract

Purpose To evaluate vitrectomy with subretinal tissue plasminogen activator (t-PA) injection, and air tamponade, followed by intravitreal anti-vascular endothelial growth factor (VEGF) therapy for submacular hemorrhage in polypoidal choroidal vasculopathy (PCV). Design Prospective, interventional case series. Methods setting: Two clinics. patients: Fifteen eyes of 15 consecutive patients (mean age 72 ± 7 years) with submacular hemorrhage attributable to PCV. inclusion criteria: PCV diagnosis with unorganized submacular hemorrhage greater than 500 μm thick. exclusion criteria: Submacular hemorrhage attributable to macular diseases (eg, high myopia, typical age-related macular degeneration, retinal angiomatous proliferation, and angioid streaks). intervention: Vitrectomy with 4000 IU t-PA injected subretinally and fluid/air exchange. Patients remained facedown for 3 days after surgery. Anti-VEGF drugs were administered as exudative changes required. main outcome measures: Submacular hemorrhage displacement from the macula and changes in best-corrected visual acuities (BCVAs). Results Mean time from onset to surgery was 9.5 ± 4.5 (range, 5-21) days. Mean follow-up period was 9.4 ± 3.1 (range, 6-17) months. Surgery successfully displaced submacular hemorrhages from the macula in all eyes. Mean BCVA at baseline (0.98 ± 0.44) had improved significantly both 1 month after surgery (0.41 ± 0.25, P

Original languageEnglish
Pages (from-to)683-689
Number of pages7
JournalAmerican Journal of Ophthalmology
Volume159
Issue number4
DOIs
Publication statusPublished - Apr 1 2015

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Vitrectomy
Tissue Plasminogen Activator
Hemorrhage
Vascular Endothelial Growth Factor A
Visual Acuity
Angioid Streaks
Air
Myopia
Macular Degeneration
Ambulatory Surgical Procedures
Outcome Assessment (Health Care)
Injections
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Ophthalmology
  • Medicine(all)

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Submacular hemorrhage in polypoidal choroidal vasculopathy treated by vitrectomy and subretinal tissue plasminogen activator. / Kimura, Shuhei; Morizane, Yuki; Hosokawa, Mio; Shiode, Yusuke; Kawata, Tetsuhiro; Doi, Shinichiro; Matoba, Ryo; Hosogi, Mika; Fujiwara, Atsushi; Inoue, Yasushi; Shiraga, Fumio.

In: American Journal of Ophthalmology, Vol. 159, No. 4, 01.04.2015, p. 683-689.

Research output: Contribution to journalArticle

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