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Marwan Abdulaal, Jacobi Robertson, Madison T Moore, Joseph M Coney; Subretinal Pneumatic Displacement without Tissue Plasminogen Activator for Submacular Hemorrhage: One-year Outcomes.. Invest. Ophthalmol. Vis. Sci. 2021;62(8):3663.
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To evaluate the outcome of pneumatic displacement of submacular hemorrhage with Subretinal Air and without tissue plasminogen activator (TPA) for thick submacular hemorrhages (SMH).
Retrospective analysis of patients with submacular hemorrhage managed surgically via pneumatic displacement without TPA from 2015 and 2020. Surgical intervention across all doctors included subretinal Balanced Saline Solution (BSS) infusion with subretinal sterile air, and intraocular gas tamponade with and without postsurgical anti-vascular endothelial growth factor (VEGF) injection. 24 patients with SMH and at least 8 months of follow up were identified. All medical records and color fundus photographs were reviewed for data collection. The primary outcome measure was best-corrected visual acuity (BCVA) 12 months after treatment. Secondary outcome measures included central retinal thickness (CRT), recurrence rate, and complications.
Patients had a mean age of 81 ± 8.6 years. Wet age-related macular degeneration was the most common etiology associated with thick SMH (92%). Complete blood displacement was observed by final follow up in 92% of the cases and none in 8.0%. Mean logMAR BCVA improved from 1.2 ± 0.27 (20/320 at baseline) to 0.9 ± 0.42 (Snellen 20/160; p = 0.001) at final follow-up. 63% of the patients gained at least 2 lines by the 12 months of follow up. Mean central retinal thickness was also improved from 569µ ± 220 at baseline to 252µ ± 63 by 12 months of follow up (P<0.001). Early postoperative complications included vitreous hemorrhage in two cases and retinal detachment in 2 patients. It was noted that 11 patients (46%) developed subretinal fibrosis at 12 months of follow up.
Vitrectomy with subretinal BSS injection and pneumatic displacement without TPA was found to be effective for displacement of thick submacular hemorrhage with improvement in visual acuity
This is a 2021 ARVO Annual Meeting abstract.
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