Atsushi Fujiwara
   Department   Kawasaki University of Medical Welfare  ,
   Position   Assistant Professor
Article types 原著
Language English
Peer review Peer reviewed
Title Outcomes of vitrectomy combined with subretinal tissue plasminogen activator injection for submacular hemorrhage associated with polypoidal choroidal vasculopathy.
Journal Formal name：Japanese journal of ophthalmology
Abbreviation：Jpn J Ophthalmol
ISSN code：16132246/00215155
Domestic / ForeginForegin
Volume, Issue, Page 63(5),pp.382-388
Author and coauthor Kimura Shuhei, Morizane Yuki, Hosokawa Mio Morizane, Shiode Yusuke, Doi Shinichiro, Hosogi Mika, Fujiwara Atsushi, Okanouchi Toshio, Inoue Yasushi, Shiraga Fumio
Publication date 2019/09
Summary PURPOSE:To examine the outcomes of vitrectomy with subretinal tissue plasminogen activator (tPA) injection and postoperative intravitreal antivascular endothelial growth factor (VEGF) injection for submacular hemorrhage (SMH) associated with polypoidal choroidal vasculopathy (PCV).STUDY DESIGN:Retrospective, consecutive case series.METHODS:Patients who underwent vitrectomy for SMH associated with PCV and who were followed up for at least 12 months were included. Surgery consisted of vitrectomy with subretinal tPA and air tamponade. Postoperative intravitreal anti-VEGF was administered pro re nata. The following were examined: best-corrected visual acuity (BCVA) at baseline, at 1 month, and at the final visit; the percentage of patients requiring anti-VEGF postoperatively; and the number of injections administered.RESULTS:This study included 23 eyes of 23 patients (21 men, 2 women) with a mean age of 72.5 ± 9.0 years. The mean duration from disease onset to surgery was 9.0 ± 6.6 days. The mean maximum SMH size was 5.8 ± 4.8 disc diameters. The mean follow-up period was 33 ± 14 months. The BCVA was significantly improved when compared with baseline 1 month after surgery and at the final visit. Postoperative anti-VEGF was required for 91% of the eyes. In eyes that underwent anti-VEGF therapy until the final visit, the mean injection number was 4.1/year.CONCLUSIONS:Vitrectomy with subretinal tPA and air tamponade improved visual acuity in patients with SMH associated with PCV. Postoperative intravitreal anti-VEGF injection maintained the improved BCVA throughout a mean period of 33 months.
DOI 10.1007/s10384-019-00679-2
PMID 31243593