Intravitreal recombinant tissue plasminogen activator without and with additional gas injection in patients with submacular haemorrhage associated with age-related macular degeneration

• Published in: Acta ophthalmologica (Oxford, England) England), 2012-11, Vol.90 (7), p.633-638
• Main Authors: Tsymanava, Anna, Uhlig, Constantin E.
• Format: Article
• Language: English
• Subjects: age-related macular degeneration; Aged; Aged, 80 and over; Combined Modality Therapy; Endotamponade; Female; Fibrinolytic Agents - therapeutic use; Fluorocarbons - therapeutic use; Gases - therapeutic use; Humans; Intraocular Pressure - physiology; Intraoperative Complications; Intravitreal Injections; Macular degeneration; Male; Medical research; Middle Aged; Ophthalmology; pneumatic displacement; Postoperative Complications; Recombinant Proteins; Retinal Hemorrhage - drug therapy; Retinal Hemorrhage - physiopathology; Retrospective Studies; submacular haemorrhage; Sulfur Hexafluoride - therapeutic use; tissue plasminogen activator; Tissue Plasminogen Activator - therapeutic use; Visual Acuity - physiology; Wet Macular Degeneration - drug therapy; Wet Macular Degeneration - physiopathology
• ISSN: 1755-375X; 1755-3768
• DOI: 10.1111/j.1755-3768.2011.02115.x

. Purpose:  To compare intravitreal recombinant tissue plasminogen activator (rt‐PA) treatment with and without gas injection in patients with submacular haemorrhage associated with age‐related macular degeneration. Methods:  We conducted a retrospective, non‐randomized comparative case study of 110 eyes from 76 women and 34 men (mean age 78.1 ± 6.9 years). Evaluations of the data were performed for baseline visit (t1), and visits 1–3 weeks (t2), 3 months (t3) and 6 months after (t4). The patients were classified according to gas treatment into group A (without gas, n = 46) and group B (with gas, n = 64) and according to rt‐PA‐dosage into group A1 and B1 (50 μg), group A2 and B2 (100 μg), and group A3 and B3 (200 μg). Results:  At t4, the patients in group A had a median increase of 0.4 logMAR, and those in group B had a decrease of 0.1 logMAR (p = 0.183). The best corrected visual acuity (BCVA) remained stable or increased in 55% and 62% of patients in groups A and B, respectively (p = 0.151), in 50% and 68% of patients in groups A1 and B1, respectively (p = 0.620), in 40% and 100% of patients in groups A2 and B2, respectively (p = 0.250), and in 75% and 63% of patients in groups A3 and B3, respectively (p = 0.463). Complications were observed in 13.6% of patients. Conclusions:  Best results were obtained in patients treated with 50 and 100 μg of rt‐PA and in those cases BCVA development was more beneficial if additional gas was injected.