1. Prognostic factors for visual acuity improvement after treatment of submacular hemorrhage secondary to exudative age-related macular degeneration.
- Author
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Barayev E, Tiosano A, Zlatkin R, Elul R, Dotan A, Hadayer A, Gal-Or O, and Ehrlich R
- Subjects
- Humans, Retrospective Studies, Male, Female, Aged, 80 and over, Prognosis, Fibrinolytic Agents therapeutic use, Fibrinolytic Agents administration & dosage, Fluorescein Angiography, Aged, Endotamponade, Follow-Up Studies, Visual Acuity physiology, Tomography, Optical Coherence, Retinal Hemorrhage etiology, Retinal Hemorrhage diagnosis, Retinal Hemorrhage therapy, Retinal Hemorrhage physiopathology, Wet Macular Degeneration diagnosis, Wet Macular Degeneration complications, Wet Macular Degeneration physiopathology, Wet Macular Degeneration drug therapy, Vitrectomy, Tissue Plasminogen Activator administration & dosage, Tissue Plasminogen Activator therapeutic use, Intravitreal Injections
- Abstract
Purpose: To recognize prognostic factors for better final visual acuity (VA) in patients presenting with submacular hemorrhage (SMH) secondary to exudative age-related macular degeneration ., Methods: This retrospective study included patients who presented to a tertiary ophthalmology department between 2012 and 2019 with SMH and were treated by pars plana vitrectomy (PPV) or injection of tissue plasminogen activator (tPA) with pneumatic displacement. Baseline characteristics included demographic data, VA and optical coherence tomography (OCT) characteristics of the SMH. Patients were divided into groups by improvement of at least 2 lines in BCVA (best corrected visual acuity), and by having a final BCVA better than 20/200., Results: Forty-three eyes of 43 patients were included. Mean age was 86.72 ± 7.18. Prognostic factors for final VA better than 20/200 included better VA at presentation (1.25 vs 1.90 logMAR, p < 0.001), smaller area of SMH in the infra-red image (19.47 mm
2 vs 38.45 mm2 , p = 0.024), and lower height of SMH as measured by OCT (713.5 µm vs 962.5 µm, p = 0.03). Third of the patients improved in ≥2 lines from presentation, all in the group of the pneumatic and TPA displacement., Conclusion: Smaller SMHs with good VA at presentation have a better chance for improvement and result in a better final VA. These patients may benefit the most from pneumatic displacement of the SMH with intravitreal tPA and gas., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.- Published
- 2024
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