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Gary Shienbaum, Harry W. Flynn, Jr., Carlos Alexandre A. Garcia Filho, Philip J. Rosenfeld; Management of Submacular Hemorrhage Secondary to Neovascular Age-Related Macular Degeneration with Anti-Vascular Endothelial Growth Factor Monotherapy. Invest. Ophthalmol. Vis. Sci. 2012;53(14):5165.
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To report the visual and anatomic outcomes of anti-vascular endothelial growth factor (VEGF) monotherapy in the management of significant submacular hemorrhage secondary to neovascular age-related macular degeneration (AMD).
Retrospective, interventional, consecutive case series. Thirteen eyes of 12 patients with neovascular AMD and fovea involving submacular hemorrhage comprising greater than 50% of the lesion area were evaluated. Treatment consisted of multiple injections of ranibizumab (9 eyes) or bevacizumab (4 eyes). Central lesion thickness was measured to be the distance from the internal limiting membrane to Bruchs membrane at the center of the fovea on spectral-domain optical coherence tomography (SD-OCT) images. Snellen visual acuity was converted to approximate ETDRS letter score for the purpose of statistical analysis. Main outcome measures included mean visual acuity change from baseline, mean central lesion thickness change from baseline, mean number of injections at 6 months, and adverse events.
The mean follow-up period was 9.3 months. The mean change in approximate ETDRS letter score from baseline was +12.2 letters at 3 months (P = 0.01) and + 23.3 letters at 6 months (P = 0.002). The mean number of injections at 6 months was 4.7. The mean OCT central lesion thickness decreased from 766 μm to 332 μm at 6 months (P = 0.02).
Eyes with submacular hemorrhage secondary to neovascular AMD may experience significant visual improvements when managed with anti-VEGF monotherapy.
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