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Graefe's Archive for Clinical and Experimental Ophthalmology

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01.03.2013 | Retinal Disorders

Recombinant tissue plasminogen activator, vitrectomy, and gas for recent submacular hemorrhage displacement due to retinal macroaneurysm

verfasst von: Elsbeth J. T. van Zeeburg, Matteo G. Cereda, Jan C. van Meurs

Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology | Ausgabe 3/2013

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Abstract

Background

The visual prognosis of submacular hemorrhages caused by a retinal arterial macroaneurysm (RAM) is poor if left untreated. The use of recombinant tissue plasminogen activator (rtPA) has frequently been reported to displace submacular hemorrhages from the foveal area in patients with age-related macular degeneration. This study aims to investigate the results of displacement of recent-onset submacular hemorrhages due to RAM.

Methods

Institutional retrospective interventional case series of 12 patients with macular hemorrhage due to RAM, who underwent pars plana vitrectomy (PPV); followed in 11 by submacular injection of rtPA and gas tamponade. The main outcome measures were displacement of the hemorrhage, complication rate, and visual acuity at 1 month after surgery and at the last follow-up visit.

Results

One month after surgery, the hemorrhage had been successfully displaced in ten out of 11 patients. In these ten patients, visual acuity (VA) increased by a mean of 1.2 logMAR at 1 month after surgery. At the last follow-up visit, the mean increase was 1.5 logMAR. Complications consisted of a vitreous hemorrhage and hyphema, retinal detachment, a new submacular hemorrhage, and vitreous hemorrhage after argon laser retinal photocoagulation of the RAM.

Conclusions

PPV with submacular rtPA and gas injection may successfully displace a recently developed submacular hemorrhage in patients with RAM, with a marked improvement in VA that is likely to be greater than if left untreated.

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Titel: Recombinant tissue plasminogen activator, vitrectomy, and gas for recent submacular hemorrhage displacement due to retinal macroaneurysm
verfasst von: Elsbeth J. T. van Zeeburg
Matteo G. Cereda
Jan C. van Meurs
Publikationsdatum: 01.03.2013
Verlag: Springer-Verlag
Erschienen in: Graefe's Archive for Clinical and Experimental Ophthalmology / Ausgabe 3/2013
Print ISSN: 0721-832X
Elektronische ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-012-2116-3

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Recombinant tissue plasminogen activator, vitrectomy, and gas for recent submacular hemorrhage displacement due to retinal macroaneurysm

Abstract

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Results

Conclusions

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