Tissue plasminogen activator and gas avoided surgery in approximately 80% of patients.
Visual acuity outcome in patients with subretinal hemorrhage - office procedure vs. surgical treatment.
Alon Tiosano … Rita Ehrlich
European journal of ophthalmology · 2023
Purpose
To evaluate the effects of intravitreal injection of tissue plasminogen activator (tPA) and gas vs. pars plana vitrectomy (pars plana vitrectomy) surgery as first-line treatment for subretinal hemorrhage.
Methods
Retrospective study of 107 adults treated for subretinal hemorrhage at a tertiary hospital during 2008-2019; 51 received injection of tPA and gas and 56 underwent pars plana vitrectomy.
n = 107 adults
Approximately 80%
Results
Approximately 80%
avoided the need for surgery after the injection treatment
n = 107 adults
More results
Overall follow-up time was longer in the pars plana vitrectomy group (median 4.9 vs 3.28 years, p = 0.005).
The hemorrhage was displaced in a similar percentage of patients in the tPA-and-gas group (n = 40,78.4%) and the pars plana vitrectomy group (n = 45,80.4%) (p = 0.816).
More results
Visual acuity (in LogMAR) was similar in the two groups prior to the diagnosis of subretinal hemorrhage but better in the tPA-and-gas group at the end of follow-up (p < 0.001).
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Conclusion · 1 of 2
Injection of gas and tPA can be done immediately following diagnosis of subretinal hemorrhage as an office procedure. Visual acuity outcome is good, with a high rate of blood displacement.
Conclusion · 2 of 2
About 20% of patients might require additional pars plana vitrectomy as secondary intervention.
