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P. L. Goodwin, R. M. Feist, M. E. Tomlinson; Treatment Options for Submacular Hemorrhage Associated With Choroidal Neovascular Membrane. Invest. Ophthalmol. Vis. Sci. 2009;50(13):6070.
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To evaluate the surgical treatment options for submacular hemorrhage associated with choroidal neovascular membrane (CNVM)
The authors performed a retrospective clinical case series examining the medical records of 65 patients (66 eyes) that received surgery for submacular hemorrhage by one of five approaches: Group 1 = submacular TPA alone (SMTPA) (25 eyes), Group 2 = SMTPA with intravitreal Avastin (16 eyes), Group 3 = SMTPA with submacular Avastin (5 eyes), and Group 4 = SMTPA with intravitreal triamcinolone acetonide (20 eyes). Primary outcomes analyzed were visual acuity, recurrent hemorrhage and postoperative complications.
The four groups were equivalent in age and gender. The patients in Group 2 showed the best postoperative visual acuity outcomes with 62.5% of patients improving greater than or equal to 2 lines at 1 month and 50% showing similar improvement at last visit (mean follow-up interval 380 days). Group 4 patients demonstrated the least improvement with only 30% of patients gaining greater than or equal to 2 lines at last follow-up. Group 1 had the highest rate of recurrent hemorrhage at 28% (7/25). A total of 4 patients experienced postoperative retinal detachments (6.1%) with only one occurring in Group 2 (6.25%).
The adjunctive use of intravitreal Avastin when using SMTPA for submacular hemorrhage associated with CNVM may lead to better visual acuity outcomes with no significant rate of increased postoperative complications.
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