1. Intravitreous injection of bevacizumab, tissue plasminogen activator, and gas in the treatment of submacular hemorrhage in age-related macular degeneration
- Author
-
Winfried Goebel, Thomas Meigen, Tanja Guthoff, and Rainer Guthoff
- Subjects
Male ,medicine.medical_specialty ,genetic structures ,Bevacizumab ,Visual Acuity ,Angiogenesis Inhibitors ,Pilot Projects ,Antibodies, Monoclonal, Humanized ,Tissue plasminogen activator ,Macular Degeneration ,Ophthalmology ,Age related ,Subretinal hemorrhage ,medicine ,Humans ,Macula Lutea ,Recombinant tissue plasminogen activator ,Initial therapy ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,Antibodies, Monoclonal ,Retinal Hemorrhage ,Tissue Inhibitor of Metalloproteinases ,General Medicine ,Macular degeneration ,medicine.disease ,eye diseases ,Choroidal Neovascularization ,Recombinant Proteins ,Vitreous Body ,Choroidal neovascularization ,Eyeglasses ,Treatment Outcome ,Drug Therapy, Combination ,Female ,sense organs ,Gases ,medicine.symptom ,Injections, Intraocular ,business ,medicine.drug - Abstract
To investigate the benefit of adding bevacizumab to intravitreal recombinant tissue plasminogen activator (rTPA) and gas as initial therapy in subretinal hemorrhage and choroidal neovascularization because of age-related macular degeneration.Thirty-eight consecutive patients with recent (1-31 days) subretinal hemorrhage who were treated with intravitreal rTPA and gas (26 patients) or with intravitreal bevacizumab, rTPA, and gas (12 patients) were included in this retrospective analysis. In all patients, a standardized antivascular endothelial growth factor therapy was followed. Testing of best-corrected visual acuity, biomicroscopy, and fundus examination were performed at 4 weeks and 7 months.The mean pretreatment best-corrected visual acuity in the rTPA/gas group was 0.08 ± 0.09 and 0.12 ± 0.13 in the bevacizumab/rTPA/gas group. After 4 weeks, it was significantly higher in the bevacizumab/rTPA/gas group (0.25 ± 0.26) than in the rTPA/gas (0.08 ± 0.1) group (P0.05). Also, after 7 months, best-corrected visual acuity was significantly higher in the bevacizumab/rTPA/gas group (0.07 ± 0.07 vs. 0.24 ± 0.35; P0.05). Reading vision could be restored in 0% (rTPA/gas) versus 50% (bevacizumab/rTPA/gas). Stabilization (0 ± 2 lines) or improvement of best-corrected visual acuity was obtained in 62% (rTPA/gas) versus 84% (bevacizumab/rTPA/gas).From our retrospective pilot study, there is a strong indication that the addition of intravitreal bevacizumab is safe and superior to the displacement of submacular hemorrhages alone with rTPA and gas.
- Published
- 2010