Schulze S. D., Hesse L.

Department of Ophthalmology, Philipps University, Marburg, Germany

Purpose: To assess factors influencing final visual outcome after displacement of subretinal hemorrhage (SRH) by intravitreally injected tissue plasminogen activator (TPA) and gas in patients suffering from agerelated macular degeneration.
Methods: We evaluated retrospectively the records of 67 Patients (32 men, 35 women, mean age 77.2 years) suffering from subretinal hemorrhage caused by age-related macular degeneration who underwent TPA and gas injection between April 1996 and October 2000. Visual acuity (preoperative, 1 week and 3 months postoperative) were analysed in respect to duration and dimension of the bleeding (diameter and thickness) and patient's age.
Results: Postoperative vision after 1 week was negatively correlated with diameter and height of the SRH (p<0.001). Three months after surgery best increase of vision was found in younger patients (p<0.05) with poor visual acuity preoperatively (p<0.001). Final visual acuity was correlated positively to the preoperative visual acuity (p<0.001) and negatively to thickness (p<0.05) and size of SRH (p<0.001). Mean postoperative vision after three month was 0.1.
Conclusion: After TPA + gas injection vision improved most in patients with a preoperative visual acuity <0.1 Increase of visual acuity one week after surgery was not a significant predictor for visual acuity three months later.

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