Hemorrhagic Age-Related Macular Degeneration Managed With Vitrectomy, Subretinal Injection of Tissue Plasminogen Activator, Gas Tamponade, and Upright Positioning
BACKGROUND AND OBJECTIVE: To investigate the outcomes of vitrectomy, subretinal tissue plasminogen (tPA) injection, gas tamponade, and upright positioning in patients with hemorrhagic neovascular age-related macular degeneration (AMD). PATIENTS AND METHODS: Retrospective, noncomparative case series. Records of patients who were diagnosed with submacular hemorrhage secondary to neovascular AMD and underwent treatment with the combined method between 2004 and 2010 were reviewed. The main outcome measure was the difference between preoperative and postoperative best corrected visual acuity (BCVA). RESULTS: In 10 eyes of 10 patients, mean preoperative and postoperative BCVA values were 1.75 and 1.23 logMAR, respectively (P = .011), after a mean follow-up time of 38.7 +/- 26.5 months (range: 10 to 71 months). Eight of 10 patients (80%) gained at least three lines. CONCLUSION: In patients with hemorrhagic neovascular AMD, treatment with vitrectomy, subretinal tPA injection, gas tamponade, and upright positioning was associated with better visual outcomes than those reported for patients with untreated disease.