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Masato Fujikawa, Osamu Sawada, Tomoko Sawada, Yoshitsugu Saishin, Hajime Kawamura, Masahito Ohji; Pneumatic Displacement In Combination With Anti-VEGF Therapy For Subretinal Hemorrhage Secondary To Polypoidal Choroidal Vasculopathy. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2844.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the efficacy of pneumatic displacement with anti-vascular endothelial growth factor (VEGF) therapy with ranibizumab or aflibercept for subretinal hemorrhage (SRH) secondary to polypoidal choroidal vasculopathy (PCV) as initial treatment.
Medical records of patients with SRH secondary to PCV were retrospectively reviewed. Treatment-naïve eyes underwent intravitreal injection of ranibizumab 0.5 mg/0.05 mL (IVR) or aflibercept 2 mg/0.05 mL (IVA) followed by pure C3F8 gas 0.3-0.5 mL as initial treatment and followed-up at least 6 months. Additional IVR or IVA was performed as needed. Pre-post best corrected visual acuity (BCVA), anatomical changes measured by optical coherence tomography (OCT), and the incidence of recurrent SRH were analyzed.
Twelve eyes of 11 patients were included. The mean (±standard deviation) age was 72.6±7.4 years old (range, 57-82). The mean baseline BCVA was 0.78±0.37 logMAR (range, 0.40-1.40). The mean follow up period was 28.5±16.8 months (range, 6-56). The mean numbers of intravitreal injections were 4.8±3.7 times (range, 1-3.7). Of anti-VEGF therapy, 9 eyes (75%) were treated with IVR alone and 2 eyes (17%) were treated with IVA alone. The treatment was switched from IVR to IVA in one eye (8%). SRHs were displaced from macular area in all eyes. Visual acuity was improved by 0.3 logMAR units or more in 6 eyes (50%) but was unchanged in 4 eyes (33%) and were worsened by 0.3 logMAR units or more in 2 eyes (17%) at final visit. No statistical significant difference was found in mean BCVA between pretreatment and final visit (P = 0.12). Pigment epithelial detachments measured by OCT were disappeared in 8 eyes (67%), of which 6 eyes improved BCVA by 0.3 logMAR or more at final visit. None of 4 eyes with persistent PEDs gained visual improvement by 0.3 logMAR or more at final visit. No recurrence of SRH was found during the follow-up period.
Pneumatic displacement in combination with anti-VEGF therapy may effective for anatomical and visual improvement and also prevent recurrence for SRH secondary to PCV.
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