title: Hemorrhagic age-related macular degeneration managed with vitrectomy, subretinal injection of tissue plasminogen activator, gas tamponade, and upright positioning.
abstract: OBJECTIVE
  To investigate the outcomes of vitrectomy, subretinal tissue plasminogen (tPA) injection, gas tamponade, and upright positioning in patients with hemorrhagic neovascular age-related macular degeneration (AMD).
  
  
  METHODS
  Retrospective, noncomparative case series. Records of patients who were diagnosed with submacular hemorrhage secondary to neovascular AMD and underwent treatment with the combined method between 2004 and 2010 were reviewed. The main outcome measure was the difference between preoperative and post-operative best corrected visual acuity (BCVA).
  
  
  RESULTS
  In 10 eyes of 10 patients, mean preoperative and postoperative BCVA values were 1.75 and 1.23 logMAR, respectively (P = .011), after a mean follow-up time of 38.7 ± 26.5 months (range: 10 to 71 months). Eight of 10 patients (80%) gained at least three lines.
  
  
  CONCLUSIONS
  In patients with hemorrhagic neovascular AMD, treatment with vitrectomy, subretinal tPA injection, gas tamponade, and upright positioning was associated with better visual outcomes than those reported for patients with untreated disease.
authors.forename: Ziya
authors.initials: Z
authors.lastname: Kapran
authors.forename: Abdullah
authors.initials: A
authors.lastname: Ozkaya
authors.forename: O Murat
authors.initials: OM
authors.lastname: Uyar
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy / Q000379:methods; D058450:Endotamponade / Q000379:methods; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005451:Fluorescein Angiography; D006801:Humans; D056965:Injections, Intraocular; D008268:Macular Degeneration / Q000150:complications*; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning / Q000379:methods*; D012166:Retinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator