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KMID : 0360220080490020267
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Journal of the Korean Ophthalmological Society
2008 Volume.49 No. 2 p.267 ~ p.273
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Intravitreal Injection of tPA and Gas for Submacular Hemorrhage Associated with Age-related Macular Degeneration
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Kim Jong-Ho
Son Jun-Hyuk
Chang Woo-Hyok
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Abstract
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Purpose : To study the results of intravitreal tissue plasminogen activator (tPA) and expansile gas injection
for the treatment of submacular hemorrhage in age-related macular degeneration (AMD).
Methods : Eleven consecutive patients (11 eyes) with submacular hemorrhage in AMD were included in this
study. All patients were treated with intravitreal injections of tPA and C3F8 gas. Postoperatively, patients’
follow-up period were at least 3 months. Outcome measures included early and final visual acuity, age, disc
areas of hemorrhage, duration of symptoms, displacement of blood from the fovea, and final macular status.
Results : The maximum diameter of the hematoma ranged from 2 to 10 disc diameters. The mean duration
of submacular hemorrhage was 7.5 days. Submacular blood was completely displaced in 7 patients (64%) and
partially in four (36%). Best postoperative visual acuity improved in 7 eyes; in 6 eyes (55%), the
improvement was two or more lines. Final visual acuity improved in 7 eyes (64%), remained stable in 2 eyes
(18%), and worsened in 2 eyes (18%). Choroidal neovascularization positioned at subfovea in 7 eyes (64%)
and juxtafovea in 4 eyes (36%). No significant difference was found between postoperative visual recovery
and these factors.
Conclusion : Our findings suggest that intravitreal tPA and expansile gas injection are safe and of useful for
displacing hemorrhages secondary to age-related macular degeneration. Final visual acuity was limited by the
underlying choroidal neovascularization of AMD.
J Korean Ophthalmol Soc 49(2):267-273, 2008
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KEYWORD
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Age-related macular degeneration, Submacular hemorrhage, Tissue plasminogen activator
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