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Stability of Postoperative Visual Acuity after Treatment of Submacular Hemorrhage with rt-PA and Gas (SF6) in Age-related Macular Degeneration
Steller A., Gerke E.,
Klinikum Wuppertal GmbH, Augenklinik (Wuppertal)
Purpose: Treatment of submacular hemorrhage with recombinant tissue plasminogen activator (rt-PA) and gas induces blood displacement out of the fovea by maintaining prone positioning. The underlying disease e.g. the choroidal neovascularisation remains untreated. Nevertheless, it has been noted, that the visual results of this method are more favorable than those expected in the natural course (Averbukh et al., Ophthalmology 2000, 107:2018-2019). Contributing longtime results the present study intends to give more information concerning this phenomenon.
Method: 45 consecutive eyes were treated using a standardized procedure (duration of hemorrhage £ 1 week, area of hemorrhage 1-5 disc areas, 50 µg rt-PA, 0,5 ml SF6 24 hours later, prone positioning for three days). Those with a follow-up of ³ 6 months were included in the study.
Results: 25 eyes from 25 patients fulfilled the criteria. Postoperative visual acuity (3 to 7 days) was improved or unchanged in 22 eyes and worse in 3 eyes. Comparison of postoperative visual acuity and visual acuity after follow-up of an average of 14,2 months (range, 6-28 months) reveals an improvement in 9 eyes, no change in 7 eyes and a deterioration in 9 eyes. A second treatment was performed in 2 eyes and photocoagulation in 1 eye.
Conclusions: Regarding the fact that after more than 1 year in about 2/3 of the eyes the postoperative visual acuity is stable or even better, it may be suggested, that treatment with rt-PA and gas may influence also the choroidal neovascularisation.