title: Efficacy of Vitrectomy Combined with Subretinal rtPA Injection with Gas or Air Tamponade.
abstract: BackgroundFunctional and anatomical outcome after vitrectomy with rtPA combined with gas or air tamponade.Patients and methodsRetrospective analysis of pseudophakic patients treated with subretinal rtPA and gas or air tamponade. The primary endpoint was displacement of haemorrhage six months after surgery. The secondary endpoints were visual acuity (BCVA), haemorrhage diameter (MHD) and central macular thickness (CMT), as measured by SD-OCT.Results53 of 85 eyes were pseudophakic. 27 of these eyes were treated with air tamponade and 26 with gas tamponade. For patients with air tamponade, the mean BCVA improved from 20/530 to 20/355 (p = 0.01). MHD and CMT decreased from 6386 ± 2281 µm to 3805 ± 2397 µm (p < 0.001) and 895 ± 592 µm to 532 ± 386 µm (p < 0.001), respectively. For patients with gas tamponade, the mean BCVA improved only slightly, from 20/471 to 20/394 (p = 0.17). MHD and CMT exhibited statistically significant decreases from 6759 ± 1773 µm to 3525 ± 1548 µm (p < 0.001) and 1089 ± 587 µm to 537 ± 251 µm (p < 0.001), respectively.ConclusionsVitrectomy with subretinal rtPA injection has strong functional and anatomical effects on submacular haemorrhages with both gas and air tamponade.
authors.affiliation: University Eye Clinic Basel, Centre for Ophthalmology, Basel, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Waizel
authors.affiliation: University Eye Clinic Basel, Centre for Ophthalmology, Basel, Switzerland.
authors.forename: M G
authors.initials: MG
authors.lastname: Todorova
authors.affiliation: Knappschaft Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach/Saar.
authors.forename: A
authors.initials: A
authors.lastname: Rickmann
authors.affiliation: University Eye Clinic Tuebingen, Centre for Ophthalmology, Tuebingen.
authors.forename: B R
authors.initials: BR
authors.lastname: Blanke
authors.affiliation: Knappschaft Eye Clinic Sulzbach, Knappschaft Hospital Saar, Sulzbach/Saar.
authors.forename: P
authors.initials: P
authors.lastname: Szurman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000388:Air; D003131:Combined Modality Therapy / Q000379:methods; D058450:Endotamponade / Q000379:methods*; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005740:Gases / Q000627:therapeutic use; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000008:administration & dosage; D012166:Retinal Hemorrhage / Q000175:diagnosis* / Q000628:therapy*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage; D016896:Treatment Outcome; D014792:Visual Acuity / Q000187:drug effects; D014821:Vitrectomy / Q000379:methods*
chemical_list: D005343:Fibrinolytic Agents; D005740:Gases; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator