Management of Acute Submacular Hemorrhage with Intravitreal Injection of Tenecteplase, Anti-vascular Endothelial Growth Factor and Gas.
10.3341/kjo.2016.30.3.192
- Author:
Jung Pil LEE
1
;
Jun Sang PARK
;
Oh Woong KWON
;
Yong Sung YOU
;
Soon Hyun KIM
Author Information
1. Retina Center, Nune Eye Hospital, Seoul, Korea. kim1441@gmail.com
- Publication Type:Original Article
- Keywords:
Anti-vascular endothelial growth factor;
Expansile gas;
Intravitreal injection;
Submacular hemorrhage;
Tenecteplase
- MeSH:
Acute Disease;
Aged;
Aged, 80 and over;
Female;
Fibrinolytic Agents/administration & dosage;
Fluorescein Angiography;
Fluorocarbons/*administration & dosage;
Follow-Up Studies;
Fundus Oculi;
Humans;
Intravitreal Injections;
Macula Lutea/*diagnostic imaging;
Male;
Middle Aged;
Retinal Hemorrhage/diagnosis/*drug therapy;
Retrospective Studies;
Tissue Plasminogen Activator/*administration & dosage;
Tomography, Optical Coherence;
Treatment Outcome;
Vascular Endothelial Growth Factor A/antagonists & inhibitors;
Visual Acuity
- From:Korean Journal of Ophthalmology
2016;30(3):192-197
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To evaluate the visual and anatomical outcomes for neovascular age-related macular degeneration with submacular hemorrhage after intravitreal injections of tenecteplase (TNK), anti-vascular endothelial growth factor (VEGF) and expansile gas. METHODS: This study was a retrospective clinical case series following 25 eyes of 25 patients. All patients received a triple injection using 0.05 mL TNK (50 µg), 0.05 mL anti-VEGF and 0.3 mL of perfluoropropane gas. Retreatment with anti-VEGF was performed as needed. Preoperative and postoperative best-corrected visual acuity and central retinal thickness were analyzed. RESULTS: The mean logarithm of the minimum angle of resolution of best-corrected visual acuity improved significantly from 1.09 ± 0.77 at baseline to 0.52 ± 0.60 at 12 months (p < 0.001). The mean central retinal thickness also improved significantly from 545 ± 156 at baseline to 266 ± 107 at 12 months (p < 0.001). A visual improvement of 0.3 logarithm of the minimum angle of resolution unit or more was achieved in 15 eyes (60%). During the 12 postoperative months, an average of 4.04 intravitreal anti-VEGF injections was applied. CONCLUSIONS: A triple injection of TNK, anti-VEGF, and a gas appears to be safe and effective for the treatment of submacular hemorrhage secondary to neovascular age-related macular degeneration.
