Pneumatic Displacement of Submacular Hemorrhage

Gopalakrishan, Mahesh; Anantharaman, Giridhar; Bhat, Savita; Saikumar, Seshadri J; Elias, Anna; Sandhya, N.

doi:10.1097/01.iae.0000231544.43093.40

Cited by 44 publications

(14 citation statements)

References 13 publications

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“…Ohji et al reported that when a subretinal hemorrhage is relatively fresh, only injection of gas can remove it from the subfoveal space [8]. However, Gopalakrishan et al reported that pneumatic displacement without tPA may not be worthwhile in eyes with a submacular hemorrhage, due to wet AMD [22]. More recently, the addition of intravitreal bevacizumab to the injection of tPA and gas is reported to be safe, and superior to the displacement of submacular hemorrhage alone with tPA and gas [23,24].…”

Section: Discussionmentioning

confidence: 96%

Pneumatic displacement of submacular hemorrhage with or without tissue plasminogen activator

Mizutani

Yasukawa

Ito

et al. 2011

Graefes Arch Clin Exp Ophthalmol

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Intravitreal SF(6) gas plus tPA may be well-accepted, with good visual outcomes and no remarkable complications for treating submacular hemorrhage secondary to AMD. tPA is not recommended for ruptured retinal arterial macroaneurysms, because of a higher incidence of subsequent vitreous hemorrhage. Pneumatic displacement of submacular hemorrhage without tPA may provide good visual outcomes with less re-bleeding.

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Section: Discussionmentioning

confidence: 96%

Pneumatic displacement of submacular hemorrhage with or without tissue plasminogen activator

Mizutani

Yasukawa

Ito

et al. 2011

Graefes Arch Clin Exp Ophthalmol

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“…Gopalakrishan et al ,[4] have reported a series of 20 cases of SMH who were treated with pneumatic displacement out of which five had AMD. In these patients they concluded that pneumatic displacement without TPA had poor results.…”

Section: Discussionmentioning

confidence: 99%

Pneumatic displacement and intravitreal bevacizumab: A new approach for management of submacular hemorrhage in choroidal neovascular membrane

Chawla

Misra

Khemchandani

2009

Indian J Ophthalmol

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Choroidal neovascular membrane (CNVM) is one of the most common causes of submacular hemorrhage (SMH). Conventional treatment involves management of the SMH with pneumatic displacement with or without tissue plasminogen activator (TPA) followed by intravitreal injection of bevacizumab in a second sitting. We decided to assess the efficacy of treating SMH secondary to CNVM with pneumatic displacement using sulphur hexafluoride (SF6) gas and intravitreal bevacizumab. Four patients with SMH secondary to CNVM were included in this study. Intravitreal bevacizumab, 0.05 ml, along with 0.5 ml of SF6 was injected through the pars plana into the vitreous cavity. Postoperative best corrected visual acuity improved in all eyes with complete or partial displacement of SMH out of the foveal area.

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“…In three studies, only intravitreal gas injection was used in an attempt to displace the hemorrhage [21,22,23]. Four studies employed either gas injection or both rtPA and gas injected intravitreally, depending on the study arm [24,25,26,27].…”

Section: Resultsmentioning

confidence: 99%

Literature Review of Recombinant Tissue Plasminogen Activator Used for Recent-Onset Submacular Hemorrhage Displacement in Age-Related Macular Degeneration

Zeeburg

Meurs

2012

Ophthalmologica

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Aims: To review and discuss the literature on recombinant tissue plasminogen activator (rtPA) for the treatment of a recent-onset submacular hemorrhage in patients with age-related macular degeneration. Methods: The administration technique of rtPA, the use of additional gas and vascular endothelial growth factor inhibitors (anti-VEGF), and the displacement rate of submacular hemorrhage and complications were noted from published reports, and a case series from the Rotterdam Eye Hospital (REH). Results: 38 studies with a total of 1,185 patients (1,176 eyes), and 28 patients from the REH were analyzed. Several methods for rtPA administration are available, which can be divided into two groups: submacular rtPA administration with vitrectomy; or intravitreal rtPA administration without vitrectomy. In both groups, the administration of gas and/or anti-VEGF agents could be additional. There appears to be no clear difference in complete displacement or complication rate between the more or the less invasive treatment groups. Conclusion: Although intravitreal injection of rtPA and gas only was reported to be as effective as subretinal rtPA with vitrectomy and gas, recent studies tend to use vitrectomy. These data underscore the need for a randomized controlled trial to choose the most effective and safe method of rtPA administration.

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Pneumatic Displacement of Submacular Hemorrhage

Abstract: The results of pneumatic displacement of submacular hemorrhage using perfluoropropane gas are encouraging, thus questioning the role of tPA in the management of such cases.

Cited by 44 publications

References 13 publications

Pneumatic displacement of submacular hemorrhage with or without tissue plasminogen activator

Pneumatic displacement of submacular hemorrhage with or without tissue plasminogen activator

Pneumatic displacement and intravitreal bevacizumab: A new approach for management of submacular hemorrhage in choroidal neovascular membrane

Literature Review of Recombinant Tissue Plasminogen Activator Used for Recent-Onset Submacular Hemorrhage Displacement in Age-Related Macular Degeneration

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