Management of submacular massive haemorrhage in age‐related macular degeneration: comparison between subretinal transplant of human amniotic membrane and subretinal injection of tissue plasminogen activator
Autor: | Ruggero Tartaro, Tomaso Caporossi, Stanislao Rizzo, Leandro Oliverio, Lorenzo Governatori, Daniela Bacherini, Laura Di Leo |
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Rok vydání: | 2021 |
Předmět: |
Pars plana
medicine.medical_specialty Visual acuity genetic structures medicine.medical_treatment Vitrectomy Macular Degeneration Postoperative Complications Fibrinolytic Agents Ophthalmology medicine Humans Amnion Fluorescein Angiography Retrospective Studies business.industry Retinal Hemorrhage General Medicine Macular degeneration medicine.disease eye diseases Transplantation Choroidal neovascularization medicine.anatomical_structure Tissue Plasminogen Activator sense organs Implant medicine.symptom Complication business Tomography Optical Coherence |
Zdroj: | Acta Ophthalmologica. 100 |
ISSN: | 1755-3768 1755-375X |
Popis: | PURPOSE Macular neovascularization (MNV) can complicate age-related macular degeneration (AMD) and lead to severe visual acuity reduction. Massive submacular haemorrhage (SMH) is a sight-threatening complication of MNV and a challenge in the management of complications related to MNV in AMD since the effects of anti-vascular endothelial growth factor treatment alone are insufficient. Here, we evaluate the different postoperative outcomes of patients affected by MNV complicated by SMH that underwent subretinal implant of human amniotic membrane (hAM) or subretinal injection of tissue plasminogen activator (tPA). METHODS This is a retrospective, consecutive, comparative, non-randomized interventional study. We included 44 eyes of 44 patients affected by AMD complicated by MNV and SMH. Twenty-two eyes underwent a pars plana vitrectomy (PPV), SMH and neovascular membrane removal, with a subretinal implant of hAM and silicone oil, and 22 eyes underwent PPV, subretinal injection of tPA, and 20% sulphur hexafluoride. The primary study outcome was visual acuity improvement. Secondary outcomes were postoperative complications, and MNV recurrence and optical coherence tomography (OCT)-Angiography parameters correlated with best-corrected visual acuity (BCVA). RESULTS Mean preoperative BCVA was 1.9 logarithm of the minimal angle of resolution (logMAR) in the amniotic membrane-group and 2 logMAR in the tPA-group. The mean final BCVA values were 1.25 and 1.4 logMAR, respectively, with a statistically significant difference. Optical coherence tomography (OCT)-Angiography scan was be used to evaluate the retinal vascularization in the treated eye. CONCLUSION Both techniques report similar VA improvements and postoperative complications. However, transplantation of hAM seems to have a significant benefit in inhibiting MNV recurrence. |
Databáze: | OpenAIRE |
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