Intravitreal Bevacizumab Therapy for Neovascular Age-related Macular Degeneration with Large Submacular Hemorrhage

Stifter, Eva; Michels, Stephan; Prager, Franz; Georgopoulos, Michael; Polak, Kaija; Hirn, Cornelia; Schmidt‐Erfurth, Ursula

doi:10.1016/j.ajo.2007.07.034

Cited by 91 publications

(72 citation statements)

References 36 publications

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“…26,27 In a retrospective study, the treatment effect of intravitreal bevacizumab monotherapy was evaluated as treatment options for neovascular AMD with subretinal haemorrhage. 28 In contrast to our study, the authors also included eyes with a submacular haemorrhage not directly beneath the fovea. They observed a visual improvement of X1 and X3 lines in 38% (8 of 21) and Figure 1 Change from baseline VA 4 months after initial treatment for each of the 20 evaluated eyes in rTPA/gas/anti-VEGF group (top) and for each of the 10 evaluated eyes in anti-VEGF monotherapy group (bottom).…”

Section: Treatment Of Extensive Subfoveal Haemorrhage S Sacu Et Almentioning

confidence: 92%

Management of extensive subfoveal haemorrhage secondary to neovascular age-related macular degeneration

Sacu

Stifter

Vécsei-Marlovits

et al. 2008

Eye

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Section: Treatment Of Extensive Subfoveal Haemorrhage S Sacu Et Almentioning

confidence: 92%

Management of extensive subfoveal haemorrhage secondary to neovascular age-related macular degeneration

Sacu

Stifter

Vécsei-Marlovits

et al. 2008

Eye

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“…However, if the CNVs are not treated at the same time with anti-VEGF, any visual improvement is likely to be short-lived. Although ranibizumab is diluted by the rtPA, this dilution is much less than the conventional 21 in similar patients showed improvement in visual acuity in only 10 of 21 eyes, no change in 2, and worsening in 9 of 21 treated with intravitreal bevacizumab only. Jain et al 22 treated 14 eyes with submacular haemorrhages with intravitreal bevacizumab or ranibizumab, and showed improvement in 13 of 14 eyes.…”

Section: Discussionmentioning

confidence: 99%

Vitrectomy with subretinal tissue plasminogen activator and ranibizumab for submacular haemorrhages secondary to age-related macular degeneration: retrospective case series of 45 consecutive cases

González-López

McGowan

Chapman

et al. 2016

Eye

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Purpose To assess the efficacy of smallgauge vitrectomy with subretinal recombinant tissue plasminogen activator (rtPA) and ranibizumab for submacular haemorrhages secondary to neovascular age-related macular degeneration (nAMD), and to identify the factors associated with visual outcome. Methods A retrospective case series was performed, including all patients who had small-gauge vitrectomy with subretinal rtPA and ranibizumab for submacular haemorrhages secondary to nAMD. All patients received three consecutive monthly injections of ranibizumab after the surgery, and were reviewed monthly and treated on a pro re nata regime. Results A total of 45 eyes of 45 patients were included in the study. Mean age was 77.07 ± 9.67 years, and 32 of 45 patients (71.1%) were women. Surgery was performed on average 6.98 ± 5.70 days after the onset of symptoms, and patients were observed for a follow-up period of 12.9 ± 10.8 months. On average, visual acuity improved − 0.59 ± 0.61 LogMAR between presentation and last follow-up. Visual acuity improved in 33 patients (73.3%), remained unchanged in 10 patients (22.2%), and worsened in 2 patients (4.4%). Multiple linear regression showed that patients with smaller haemorrhages (P = 0.012) and prompt surgery (P = 0.008) had better final visual acuities. A haemorrhage area of ≤ 30 mm 2 had 91.3% sensitivity and 73.3% specificity for predicting a final visual acuity ≥ 6/60. Conclusion Small-gauge vitrectomy with subretinal rtPA and ranibizumab is effective for improving visual acuity in patients with submacular haemorrhages secondary to nAMD. Small haemorrhage area and prompt surgery are associated with better final visual acuity.

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“…Stifter et al reported improved acuity in 48% of 21 cases and reduced acuity in 43% after 4 months of bevacizumab monotherapy. 7 At 12 months, the 25% had improved and 58% had reduced acuity. In that series, the area of haemorrhage at baseline was also similar and in 33% of cases, the haemorrhage was 30 days or more old.…”

Section: Discussionmentioning

confidence: 99%

“…Although patients with sub-foveal haemorrhage greater than a disc area or 450% of total lesion area were not included in the ranibizumab phase 3 trials, other authors have shown a benefit from combination therapy or monotherapy using drugs directed against vascular endothelial growth factor. [6][7][8][9] The aim of this study was to report the efficacy and safety of ranibizumab monotherapy in the treatment of sub-foveal haemorrhage secondary to neovascular ARMD.…”

Section: Introductionmentioning

confidence: 99%

Ranibizumab monotherapy for sub-foveal haemorrhage secondary to choroidal neovascularisation in age-related macular degeneration

McKibbin

Papastefanou

Matthews

et al. 2009

Eye

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Purpose In a retrospective review, the functional effects of intra-vitreal ranibizumab monotherapy in patients with sub-foveal haemorrhage secondary to choroidal neovascularisation (CNV) in age-related macular degeneration (ARMD) are reported. Patients and methods Twelve eyes of 12 patients were treated with intra-vitreal ranibizumab (0.5 mg in 0.05 ml) in accordance with current practice. Follow-up was arranged at monthly intervals. Eleven patients completed 6 months and seven completed 12 months of follow-up. Duration of haemorrhage, lesion size, ETDRS letter score at baseline, and follow-up were analysed. Results The mean time for complete clearance of sub-retinal haemorrhage was 4.7 months (range 3-7 months). After 6 months, visual acuity was stable or improved in 7 of 11 eyes and the mean change in ETDRS letter score was þ 7.6 letters (P40.05). After 12 months, visual acuity was stable or improved in five of seven eyes and the mean change in ETDRS letter score was þ 7.3 letters (P40.05). For the seven cases with 12 months of followup, a mean of six injections were given. Two patients had a decrease in acuity of 415 ETDRS letters during follow-up. No other local or systemic side-effects were reported. Conclusions Intra-vitreal ranibizumab monotherapy may be an effective treatment for subfoveal haemorrhage secondary to CNV in ARMD.

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Intravitreal Bevacizumab Therapy for Neovascular Age-related Macular Degeneration with Large Submacular Hemorrhage

Cited by 91 publications

References 36 publications

Management of extensive subfoveal haemorrhage secondary to neovascular age-related macular degeneration

Management of extensive subfoveal haemorrhage secondary to neovascular age-related macular degeneration

Vitrectomy with subretinal tissue plasminogen activator and ranibizumab for submacular haemorrhages secondary to age-related macular degeneration: retrospective case series of 45 consecutive cases

Ranibizumab monotherapy for sub-foveal haemorrhage secondary to choroidal neovascularisation in age-related macular degeneration

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