Annals of Optometry and Contact Lens 2017;16(2):68-73.
Published online June 25, 2017.
Clinical Outcomes of Eyes with Massive Subretinal Hemorrhage Initially Treated with Intravitreal Injection of tPA, C<sub>3</sub>F<sub>8</sub> Gas and Anti-VEGF
Ji Yun Han, Seong-Woo Kim, Jaeryung Oh
Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
Received: 22 May 2017   • Revised: 7 June 2017   • Accepted: 7 June 2017
Purpose: To evaluate the clinical outcomes of eyes with massive subretinal hemorrhage (SRH) initially treated with intravitreal injection of tissue plasminogen activator (tPA), perfluoropropane (C3F8) gas and anti- vascular endothelial growth factor (anti-VEGF) (triple therapy).
Methods: Twenty one eyes of 21 patients with massive SRH followed up for ≥ 3 months after triple therapy were retrospectively reviewed. The final diagnosis of patients, efficacy and clinical outcomes of the triple therapy were investigated.
Results: The final diagnosis of 21 eyes consisted of three disease. 13 eyes (61.9%) were polypoidal choroidal vasculopathy, 4 eyes (19.0%) were age-related macular degeneration, 2 eyes (9.5%) were retinal macroaneurysm and 2 eyes (9.5%) could not be confirmed the final diagnosis. The mean size of SRH was 4.5 (±1.5) disc diameter. The visual acuity was improved in 10 eyes (47.6%), remained stable in 10 eyes (47.6%) and decreased in 1 eye (4.8%). The size of SRH and final diagnosis had not significant relationship on visual acuity change. For 12 eyes followed up for ≥ 12 months after triple therapy, the mean logMAR best-corrected visual acuity significantly improved at 12 months (p=0.023, Wilcoxon signed rank test).
Conclusions: The triple therapy of tPA, C3F8 gas and anti-VEGF could be a one of effective initial treatment modality in stabilization and maintenance of visual improvement for massive SRH.
Key Words: Massive subretinal hemorrhage; Pneumatic displacement; Tissue plasminogen activator; Vascular endothelial growth factor
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