ISSN: 2459-1777 | E-ISSN 2587-0394
Volume : 9 Issue : 4 Year : 2024
Efficacy of Simultaneous Application of Subretinal Tissue Plasminogen Activator and Bevacizumab for Submacular Hemorrhages [Beyoglu Eye J]
Beyoglu Eye J. 2023; 8(3): 198-207 | DOI: 10.14744/bej.2023.34735

Efficacy of Simultaneous Application of Subretinal Tissue Plasminogen Activator and Bevacizumab for Submacular Hemorrhages

Utku Limon, Tuğba Aydoğan Gezginaslan, Işılay Özsoy Saygın, Erdinç Bozkurt, Esra Kardes, Betül İlkay Sezgin Akçay
University of Health Sciences Umraniye Training and Research Hospital Eye Clinic Istanbul, Istanbul, Türkiye

OBJECTIVES: The aim of the study was to evaluate the patients who received simultaneous subretinal tissue plasminogen activator (tPA) and bevacizumab for submacular hemorrhages secondary to neovascular age-related macular degeneration.
METHODS: This retrospective study included patients who underwent pars plana vitrectomy (PPV) with simultaneous sub-retinal tPA and subretinal bevacizumab with 18% SF6 tamponade. Anatomical and functional results of the patients before surgery and at the 1st, 6th, and 12th months after surgery, additional treatments, and complications after PPV were evaluated.
RESULTS: Eight eyes of eight patients were included in the study. The mean age of the patients was 72.38±92.3. The mean time from the onset of symptoms to treatment was 5.13±1.88 days. The patients’ mean best-corrected visual acuity (BCVA) was 2.23±0.14 logMAR at baseline. Mean BCVA increased significantly at 1st, 6th, and 12th months to 1.68±0.47 logMAR, 1.58±0.49 logMAR, and 1.51±0.58 logMAR, respectively (p=0.001 at all). The mean central foveal thickness (CFT) in measurable patients was 836.8±627.02 µm at baseline. Mean CFT decreased significantly to 370.13±66.13 µm in the 1st month, 373.38±78.33 µm in the 6th month, and 367.75±116.43 µm in the 12th month (p<0.05). The maximum measurable subretinal hemorrhage height at baseline was 814.2±556.45 µm. The mean number of anti-VEGFs performed for 12 months after surgery was 4.13±2.1. At month 12, the ellipsoid zone could not be detected in 6 (75%) patients.
DISCUSSION AND CONCLUSION: Administration of subretinal bevacizumab and subretinal tPA effectively removes subretinal hemorrhage under the fovea. Intravitreal anti-VEGF treatment must be continued, as choroidal neovascular membrane activity continues after surgery.

Keywords: Age-related macular degeneration, bevacizumab, pars plana vitrectomy, subretinal hemorrhage, subretinal tPA

Corresponding Author: Utku Limon, Türkiye
Manuscript Language: English
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