Vitrectomy with Gas Tamponade and anti-VEGF Injections for the Management of Submacular Hemorrhage

Background

A voluminous submacular hemorrhage is a severe complication of exudative age-related macular degeneration (AMD). Without treatment, submacular hemorrhage leads to irreversible damage, both in the sensory retina and the retinal pigment epithelium (RPE) [1].

• References

• 1 Toth CA, Morse LS, Hjelmeland LM et al. Fibrin directs early retinal damage after experimental subretinal hemorrhage. Arch Ophthalmol 1991; 109: 723-729
• 2 Kim JH, Chang YS, Kim JW et al. Intravitreal anti-vascular endothelial growth factor for submacular hemorrhage from choroidal neovascularization. Ophthalmology 2014; 121: 926-935
• 3 Sacu S, Stifter E, Vécsei-Marlovits PV et al. Management of extensive subfoveal haemorrhage secondary to neovascular age-related macular degeneration. Eye 2009; 23: 1404-1410
• 4 Guthogg R, Guthoff T, Meigen T et al. Intravitreous injection of bevacizumab, tissue plasminogen activator, and gas in the treatment of submacular hemorrhage in age-related macular degeneration. Retina 2011; 31: 36-40
• 5 Treumer F, Klatt C, Roider J et al. Subretinal coapplication of recombinant tissue plasminogen activator and bevacizumab for neovascular age-related macular degeneration with submacular haemorrhage. Br J Ophthalmol 2010; 94: 48-53
• 6 Chang W, Garg SJ, Maturi R et al. Management of thick submacular hemorrhage with subretinal tissue plasminogen activator and pneumatic displacement for age-related macular degeneration. Am J Ophthalmol 2014; 157: 1250-1257
• 7 Van Zeeburg EJL, van Meurs JC. Literature review of recombinant tissue plasminogen activator used for recent-onset submacular hemorrhage displacement in age-related macular degeneration. Ophthalmologica 2013; 229: 1-14
• 8 Stanescu-Segall D, Balta F, Jackson TL. Submacular hemorrhage in neovascular age-related macular degeneration: A synthesis of the literature. Surv Ophthalmol 2016; 61: 18-32