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Jungil Han, Han Joo Cho, Young Ju Lew, Kyung Min Koh, Joo Yeon Kim; Intravitreal Ranibizumab Injections with and without Pneumatic Displacement for Treating Submacular Hemorrhage Secondary to Neovascular Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2014;55(13):4967.
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To evaluate the efficacy of intravitreal ranibizumab with and without pneumatic displacement for the treatment of submacular hemorrhage (SMH) secondary to neovascular age-related macular degeneration (nAMD).
A total of 93 treatment-naïve patients (93 eyes) with SMH secondary to nAMD were included. All patients were treated with an initial series of 3 monthly intravitreal ranibizumab injections, followed by as-needed injections. For the patients treated with pneumatic displacement, expansive gas was injected at the time of the first ranibizumab injection
Twelve months into treatment, mean best-corrected visual acuity (BCVA) of all subjects significantly improved from 1.19 ± 0.55 (20/309) at baseline to 0.96 ± 0.39 (20/182, P = 0.007). No significant difference in BCVA between ranibizumab monotherapy and combination therapy groups was observed at 12 months. However, the proportion of eyes with ≥3 line BCVA improvement was significantly higher in the combination therapy group (57.1%) than in the ranibizumab monotherapy group (37.9%; P = 0.03). Among eyes with typical nAMD (39 eyes), the proportion of eyes showing a ≥3-line improvement in BCVA was significantly higher in eyes treated with combination therapy than in eyes treated with ranibizumab monotherapy (P = 0.02). This difference was not observed in eyes with polypoidal choroidal vasculopathy (PCV, 54 eyes).
Intravitreal ranibizumab injections with and without pneumatic displacement are viable treatment options for SMH secondary to nAMD. Additional benefits of pneumatic displacement for SMH were only significant in eyes with typical nAMD and not in eyes with PCV.
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