Original articleDisplacement of Submacular Hemorrhages in Age-Related Macular Degeneration with Subretinal Tissue Plasminogen Activator and Air
Section snippets
Methods
The study was performed in a prospective manner at the Department of Ophthalmology of Yokohama City University Medical Center between January 2013 and October 2013. Institutional review board approval was obtained for this study. Each patient signed an informed consent form. The inclusion criteria were thick SMHs involving the foveal center resulting from age-related macular degeneration and extending into at least 2 quadrants, and a maximum history of symptom duration of 4 weeks. The exclusion
Results
There were 13 subjects (2 women and 11 men), and their mean age was 71 years (range, 62–87 years). The average interval between the onset of symptoms and surgery was 19 days (range, 7–40 days). Preoperative visual acuity in the affected eyes ranged from 20/100 to counting fingers. Total subfoveal blood displacement was achieved in all 13 eyes (100%; Figure 2, Figure 3, Figure 4).
All patients were followed up for a minimum of 3 months. Preoperative and postoperative visual acuity values were
Discussion
Total subfoveal displacement of the dissolved clots and satisfactory visual improvement were achieved in all 13 eyes in this study by submacular injection of tPA and air followed by maintaining a prone position overnight.
Pneumatic displacement is achieved by a simple fluid–air exchange and postoperative positioning.6, 7, 8 Because pneumatic displacement works by decreasing the buoyancy of the SMHs without increasing the buoyancy of the air, SMHs readily drift away from the macular area because
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Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.