Pneumatic displacement of acute submacular hemorrhage with and without the use of tissue plasminogen activator

摘要

Purpose. To evaluate the efficacy of C3F8 gas-assisted pneumatic displacement in the treatment of massive submacular hemorrhage, with and without the use of tissue plasminogen activator (tPA). Methods. Twenty-one eyes of 21 patients with recently developed (up to 10 days) dense submacular hemorrhage underwent intravitreal injection of pure C3Fa gas (0.4-0.5 mL) followed by face-down positioning for pneumatic displacement. Seven of them received additional intravitreal injection of 25-50 ijg tPA. The primary etiology of submacular hemorrhage was age-related macular degeneration (n=16), myopic choroidal neovascularization (n=2), retinal arterial macroaneurysm (n=2), and trauma (n=1). Visual acuity and displacement of hemorrhage were the main outcome measures. Results. Follow-up period was 6-12 months. Effective displacement of hemorrhage was obtained in 20 of 21 patients within 7 days. Final median Snellen visual acuity (0.18) was found significantly improved compared to baseline (0.03) (p<0.001). Visual acuity improvement was similar in both groups (9=0.72).Conclusions. Intravitreal injection of C3F8 effectively displaced thick submacular hemorrhage and improved visual acuity independently from primary cause. Additional tPA use in this study had no impact on the final outcomes.