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24th Annual Meeting of the German Retina Society

German Retina Society

17.06. - 18.06.2011, Aachen

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Minimally invasive surgery in submacular haemorrhage due to neovascular age-related macular degeneration

Meeting Abstract

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  • Husnia Baraki - Universitäts-Augenklinik Göttingen
  • U. Ritzau-Tondrow - Universitäts-Augenklinik Göttingen
  • H. Hoerauf - Universitäts-Augenklinik Göttingen

German Retina Society. 24th Annual Conference of the German Retina Society. Aachen, 17.-18.06.2011. Düsseldorf: German Medical Science GMS Publishing House; 2011. Doc11rg37

doi: 10.3205/11rg37, urn:nbn:de:0183-11rg378

This is the English version of the article.
The German version can be found at: http://www.egms.de/de/meetings/rg2011/11rg37.shtml

Published: June 15, 2011

© 2011 Baraki et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

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Objective: To evaluate a method for minimally invasive surgery in submacular haemorrhage (SMH) due to neovascular age-related macular degeneration (AMD). Subretinal injection of bevacizumab and recombinant tissue plasminogen activator (rTPA), core vitrectomy and application of gas (SF6) were performed through a single pars-plana port.

Methods: Consecutive interventional case series of 15 patients with SMH of at least one disc diameter and with a maximum history of 10 days. A single pars-plana port is necessary during the whole surgery. All patients underwent subretinal injection of 1.25 mg bevacizumab and 25 µg rTPA. Then approximately 2 ml pure SF6 was applicated after core vitrectomy. Testing of best corrected visual acuity (BCVA), biomicroscopy, fundus examination and optical coherence tomography were performed at 4 weeks after treatment.

Results: The mean pre-treatment BCVA improved from 0.05 (logMar 1.3±0.5) to 0.13 (logMar 0.9±0.4) (p<0.01) 4 weeks after surgery. In one case a dense vitreous haemorrhage occurred due to effusion of the SMH throug the retinotomy created by the injection canula. SMH recurred in one patient 4 weeks after treatment. No retinal tear or detachement could be observed so far. Three eyes showed a rip in the RPE after complete resolution of the haemorrhage. It remains unclear whether the rip was preexistent or caused by injection. One patient developed a secondary macular hole.

Conclusion: The presented surgery in submacular hemorrhage due to neovascular AMD appears to be relatively safe and is well tolerated by the patients. In most cases it resulted in visual improvement.