title: Intravitreal ranibizumab injections with and without pneumatic displacement for treating submacular hemorrhage secondary to neovascular age-related macular degeneration.
abstract: OBJECTIVE
  To evaluate the efficacy of intravitreal ranibizumab with and without pneumatic displacement for the treatment of submacular hemorrhage secondary to neovascular age-related macular degeneration.
  
  
  METHODS
  We retrospectively reviewed the medical records of 93 treatment-naive patients (93 eyes) with submacular hemorrhage secondary to neovascular age-related macular degeneration. All patients were treated with an initial series of 3 monthly intravitreal ranibizumab injections, followed by as-needed injections. For the patients treated with pneumatic displacement, expansive gas was injected at the time of the first ranibizumab injection.
  
  
  RESULTS
  Mean submacular hemorrhage area was 8.2 ± 5.8 disk areas, and mean symptom duration was 8.2 ± 5.2 days at baseline. Twelve months into treatment, the mean logarithm of the minimum angle of resolution of best-corrected visual acuity of all subjects significantly improved from 1.19 ± 0.55 (20/309) at baseline to 0.96 ± 0.39 (20/182, P = 0.007) at 12 months. The mean central foveal thickness also significantly improved from 473 ± 223 μm at baseline to 279 ± 134 μm (P < 0.001) at 12 months. However, no significant difference in best-corrected visual acuity and mean central foveal thickness between ranibizumab monotherapy (58 eyes) and combination therapy groups (35 eyes) was observed at 12 months.
  
  
  CONCLUSIONS
  Intravitreal ranibizumab injections with and without pneumatic displacement are viable treatment options for submacular hemorrhage secondary to neovascular age-related macular degeneration.
authors.affiliation: Department of Ophthalmology, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Konyang University College of Medicine, Seoul, South Korea.
authors.forename: Han Joo
authors.initials: HJ
authors.lastname: Cho
authors.forename: Kyoung Min
authors.initials: KM
authors.lastname: Koh
authors.forename: Jae Hui
authors.initials: JH
authors.lastname: Kim
authors.forename: Hyoung Seok
authors.initials: HS
authors.lastname: Kim
authors.forename: Jung Il
authors.initials: JI
authors.lastname: Han
authors.forename: Young Ju
authors.initials: YJ
authors.lastname: Lew
authors.forename: Tae Gon
authors.initials: TG
authors.lastname: Lee
authors.forename: Jong Woo
authors.initials: JW
authors.lastname: Kim
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D004396:Coloring Agents; D003131:Combined Modality Therapy; D058450:Endotamponade / Q000379:methods*; D005260:Female; D005451:Fluorescein Angiography; D005466:Fluorocarbons / Q000008:administration & dosage; D006801:Humans; D007208:Indocyanine Green; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D000069579:Ranibizumab; D012166:Retinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000502:physiology; D057135:Wet Macular Degeneration / Q000150:complications / Q000628:therapy*
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D004396:Coloring Agents; D005466:Fluorocarbons; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C042852:perflutren; D007208:Indocyanine Green; D013459:Sulfur Hexafluoride; D000069579:Ranibizumab