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The effect of initial intravitreal tissue plasminogen activator and gas injection on vision improvement in patients with submacular haemorrhage associated with age-related macular degeneration
- Source :
- Eye (Lond)
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- Purpose To compare visual improvements between initial intravitreal t-PA with gas injection before anti-vascular endothelial growth factor (VEGF) and anti-VEGF injection monotherapy for submacular haemorrhage (SMH) associated with age-related macular degeneration (AMD). Methods We retrospectively reviewed medical records of naive patients treated with intravitreal t-PA with gas injection before anti-VEGF (Group 1) or only with intravitreal anti-VEGF injection (Group 2) for SMH [disc area (DA) ≥ 2] associated with AMD from two institutions. Both groups received 3 monthly loads of anti-VEGF injections followed by injections as needed for AMD treatment. Changes in best-corrected visual acuity (BCVA, logMAR) between the initial visit and after 6 months of treatment were compared between two groups. Results A total of 82 patients were enroled. Of these, 32 patients and 50 patients were grouped in Groups 1 and 2, respectively. The mean change in BCVA over 6 months for Group 1 was -0.52 ± 0.88, which was significantly larger (p = 0.044) than the mean change for Group 2 (-0.15 ± 0.58). We compared visual improvements between the two groups based on the following SMH size categories: ≤5, >5, and ≤15, and >15 DA. When the SMH size was ≤5, or >5 and ≤15 DA, the mean change in BCVA was larger for Group 1 than for Group 2, but this difference was not significant. When SMH size was >15 DA, Group 1 patients exhibited a mean visual improvement of -0.79 ± 0.80, which was significantly greater (p = 0.029) than that of Group 2 (-0.06 ± 0.67). Conclusions Patients that were primarily treated for SMH associated with AMD using t-PA and gas injection (followed by anti-VEGF injection) exhibited better visual improvement than those treated with anti-VEGF monotherapy, especially in patients exhibiting larger SMH sizes (>15 DA) at the initial visit.
- Subjects :
- medicine.medical_specialty
Visual acuity
genetic structures
VEGF receptors
Visual Acuity
Tissue plasminogen activator
Article
Therapy naive
Macular Degeneration
Fibrinolytic Agents
Initial visit
Ophthalmology
Age related
medicine
Humans
In patient
Fluorescein Angiography
Retrospective Studies
biology
business.industry
Retinal Hemorrhage
Macular degeneration
medicine.disease
eye diseases
Tissue Plasminogen Activator
biology.protein
sense organs
medicine.symptom
business
medicine.drug
Subjects
Details
- ISSN :
- 14765454 and 0950222X
- Volume :
- 35
- Database :
- OpenAIRE
- Journal :
- Eye
- Accession number :
- edsair.doi.dedup.....8ecb5226820fe6376186b90c74ef160f