title: Modified Approach in Management of Submacular Hemorrhage Secondary to Wet Age-Related Macular Degeneration.
abstract: OBJECTIVE
  The aim of this study was to evaluate the surgical outcomes of a modified approach in the management of thick submacular hemorrhage in patients with wet age-related macular degeneration.
  
  
  METHODS
  This was a retrospective study.
  
  
  METHODS
  A retrospective chart review was performed on 10 eyes of 10 patients with submacular hemorrhage secondary to wet age-related macular degeneration treated with 23-gauge pars plana vitrectomy, followed by submacular injection of recombinant tissue plasminogen activator (12.5 μg/0.1 mL), bevacizumab (2.5 mg/0.1 mL), and air (0.3 mL). Gas tamponade was given with 20% SF6 and postoperative propped-up positioning. Patients were evaluated for displacement of hemorrhage, preoperative and postoperative best-corrected visual acuity, occurrence of intraoperative and postoperative complications, and recurrence of hemorrhage. All patients were followed up for 6 months.
  
  
  RESULTS
  Displacement of the submacular bleed was achieved in all cases. Improvement of best-corrected visual acuity was seen in 8 of 10 patients. Rebleed was seen in 2 eyes that were retreated with intravitreal injection of recombinant tissue plasminogen activator, bevacizumab, and 20% SF6 gas.
  
  
  CONCLUSIONS
  This modified technique aids in the effective displacement of thick submacular hemorrhage with simultaneous treatment of the underlying choroidal neovascular membrane, which halts the disease progression resulting in significant improvement of visual acuity.
authors: From the Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors: Atul
authors: A
authors: Kumar
authors: Sangeeta
authors: S
authors: Roy
authors: Mayank
authors: M
authors: Bansal
authors: Sana
authors: S
authors: Tinwala
authors: Neelima
authors: N
authors: Aron
authors: Shreyas
authors: S
authors: Temkar
authors: Amar
authors: A
authors: Pujari
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000388:Air; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000068258:Bevacizumab / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D016684:Prone Position; D012166:Retinal Hemorrhage / Q000188:drug therapy / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*; D057135:Wet Macular Degeneration / Q000150:complications* / Q000188:drug therapy / Q000601:surgery
chemical_list: D020533:Angiogenesis Inhibitors; D005343:Fibrinolytic Agents; D000068258:Bevacizumab; D010959:Tissue Plasminogen Activator