[Combined intravitreal injection of bevacizumab and SF6 gas for treatment of submacular hemorrhage secondary to age-related macular degeneration].
OBJECTIVE
To investigate the efficacy of intravitreous bevacizumab and sulphur hexafluoride (SF(6)) for treating submacular hemorrhage secondary to age-related macular degeneration (ARMD).


METHODS
Ten eyes of 10 patients (mean age 78.4 years, +/-6.5) with recent (range 1-4 weeks, median 1.0, mean 1.5) subfoveal hemorrhage secondary to ARMD were included in this study. The size of the subretinal hemorrhage ranged from 0.85 to 21.7 mm(2) (median 6.6 mm(2), mean 9.5 mm(2), +/-8.12). All patients received combined intravitreous injections of 1.25 mg bevacizumab and 0.3 ml SF(6). Follow-up visits were done 4 weeks after treatment. Depending on the ophthalmologic findings, further treatment with antivascular endothelial growth factor (anti-VEGF) injections was planned.


RESULTS
Visual acuity improved three or more Snellen lines in six eyes (60%), remained stable in three (30%), and worsened by three or more lines in one eye (10%). Overall, displacement of blood was achieved in eight eyes (80%). In the following months, nine eyes received further injections with VEGF inhibitors. The Wilcoxon paired sample test revealed significant improvement of visual acuity in our patients (p=0.05).


CONCLUSIONS
Our findings suggest that combined intravitreous injections of bevacizumab and SF(6) have the potential to improve visual outcome in patients with subretinal hemorrhage secondary to ARMD. However, further treatment of the underlying choroidal neovascularization is mandatory.
Höhn
F
F
Augenklinik des Klinikums Ludwigshafen, Bremserstrasse 79, 68063 Ludwigshafen. hoehnf@klilu.de
Mirshahi
A
A
Hattenbach
L-O
LO
D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D004359:Drug Therapy, Combination / Q000379:methods; D005260:Female; D006801:Humans; D007267:Injections; D008266:Macula Lutea / Q000187:drug effects*; D008268:Macular Degeneration / Q000150:complications* / Q000188:drug therapy*; D008297:Male; D012166:Retinal Hemorrhage / Q000188:drug therapy* / Q000209:etiology*; D013459:Sulfur Hexafluoride / Q000008:administration & dosage*; D016896:Treatment Outcome; D014822:Vitreous Body
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D013459:Sulfur Hexafluoride