PURPOSE: To investigate the safety and efficacy of pneumatic displacement of submacular hemorrhage without the use of intravitreal tissue plasminogen activator (tPA). METHODS: In a prospective, consecutive, single-center, noncomparative, interventional case series, 20 consecutive patients with submacular hemorrhage due to various etiologies (duration, 1-30 days; visual acuity, hand movements to 20/125) were treated with intravitreal perfluoropropane gas injection followed by prone positioning for 5 days to 7 days. Patients were observed 1 day, 7 days, 30 days, 3 months, 6 months, and 1 year after the procedure. RESULTS: Submacular blood was completely or partially displaced from the fovea in 16 of 20 eyes within 7 days after the injection. Mean best-corrected visual acuity improved from 1.6 to 0.72 logarithm of minimum angle of resolution, which was statistically significant (Wilcoxon signed rank test, P = 0.001). Final visual acuity was 20/63 or better in 10 eyes (50%). The change in proportion of eyes with best-corrected visual acuity of 20/63 or better after treatment was statistically significant (McNemar test, P = 0.002). Four patients developed nonresolving vitreous hemorrhage, which necessitated vitrectomy. CONCLUSION: The results of pneumatic displacement of submacular hemorrhage using perfluoropropane gas are encouraging, thus questioning the role of tPA in the management of such cases.
PURPOSE: To investigate the safety and efficacy of pneumatic displacement of submacular hemorrhage without the use of intravitreal tissue plasminogen activator (tPA). METHODS: In a prospective, consecutive, single-center, noncomparative, interventional case series, 20 consecutive patients with submacular hemorrhage due to various etiologies (duration, 1-30 days; visual acuity, hand movements to 20/125) were treated with intravitreal perfluoropropane gas injection followed by prone positioning for 5 days to 7 days. Patients were observed 1 day, 7 days, 30 days, 3 months, 6 months, and 1 year after the procedure. RESULTS: Submacular blood was completely or partially displaced from the fovea in 16 of 20 eyes within 7 days after the injection. Mean best-corrected visual acuity improved from 1.6 to 0.72 logarithm of minimum angle of resolution, which was statistically significant (Wilcoxon signed rank test, P = 0.001). Final visual acuity was 20/63 or better in 10 eyes (50%). The change in proportion of eyes with best-corrected visual acuity of 20/63 or better after treatment was statistically significant (McNemar test, P = 0.002). Four patients developed nonresolving vitreous hemorrhage, which necessitated vitrectomy. CONCLUSION: The results of pneumatic displacement of submacular hemorrhage using perfluoropropane gas are encouraging, thus questioning the role of tPA in the management of such cases.
Authors: Seung Ha Lee; Sang Joon Lee; Yong Il Shin; Hyung Bin Lim; Jung Yeul Kim; Yong Seop Han; Ki Yup Nam Journal: Eye (Lond) Date: 2021-01-09 Impact factor: 4.456
Authors: Mustafa Gok; V Levent Karabaş; Mehmet S Aslan; Özgür Kara; Süleyman Karaman; Fatih Yenihayat Journal: Indian J Ophthalmol Date: 2017-06 Impact factor: 1.848
Authors: Giamberto Casini; Pasquale Loiudice; Martina Menchini; Francesco Sartini; Stefano De Cillà; Michele Figus; Marco Nardi Journal: Int J Retina Vitreous Date: 2019-12-11