Assessment of morphological and functional results of treatment of patients with subfoveal hemorrhage secondary to AMD

Abstract

Purpose. The aim of the study was to evaluate the morphological and functional parameters of the retina after subretinal administration of recombinant prourokinase followed by pneumodislocation in comparison with anti-VEGF (Vascular endothelial growth factor) monotherapy in the long term in patients with subfoveal hemorrhage. Material and methods. Depending on the choice of surgical treatment, the patients were divided into two groups: Group 1 – 11 patients (11 eyes) – patients receiving anti-VEGF therapy as the main treatment according to the treat and extend regimen; Group 2 – 9 patients (9 eyes) – patients who underwent translocation of submacular hemorrhage followed by intravitreal administration of anti-VEGF drugs according to the treat and extend regimen. Results. Elimination of the clot to the peripheral regions made it possible to achieve an improvement in the architectonics of the retina in the central zone, in particular, a decrease in the central thickness of the retina in the group with subretinal administration of tissue plasminogen activator by an average of 654.67 µm after 3 months. According to a comparative analysis of morphological parameters at the end of the observation period, in the 2nd group, the decrease in central foveal thickness exceeded the data shown in the 1st group by 16 times. Analysis of the height of choroidal neovascularization showed a depression of the final results 4.34 times relative to the initial values in the combined treatment group. Positive dynamics persisted throughout the entire period of treatment against the background of ongoing anti-vasoproliferative therapy. Conclusion. The technique of subretinal injection of recombinant prourokinase followed by tamponade with an air mixture used in the study demonstrates an increase in visual functions against the background of a favorable anatomical outcome. Key words: submacular hemorrhage, tissue plasminogen activator, pneumodislocation.