Submacular hemorrhage: A study amongst Indian eyes.
Date
2012-11
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Abstract
Aim:
To evaluate the management outcomes amongst various treatment modalities for submacular hemorrhage (SMH) in Indian subjects.
Settings and Design:
Retrospective, single-center study.
Materials and Methods:
Patients presenting with SMH between 1999 and 2006 were included. Treatment modalities included: vitrectomy with subretinal recombinant tissue plasminogen activator (r-tPA) assisted SMH evacuation (group 1, n = 14); pneumatic displacement with intravitreal r-tPA and gas (group 2, n = 25); and pneumatic displacement with intraocular gas (group 3, n = 7). Favorable anatomical outcome was defined as complete displacement of SMH from fovea and favorable functional outcome was defined as a gain of >2 Snellen lines from the baseline. Kruskal–Wallis, analysis of variance (ANOVA), and Chi-square tests were used to compare the three groups, while Mann–Whitney and independent t-test were used to evaluate the influence of duration and size of SMH on outcomes.
Results:
There was no difference amongst groups in terms of favorable anatomical (P = 0.121) or functional outcomes (P = 0.611). Eyes with median duration of SMH less than 7.5 days had a significantly higher probability of achieving favorable anatomical outcome compared to eyes with SMH >14.5 days (P = 0.042). However, duration of SMH did not influence functional outcome (P = 0.595). Similarly, size of SMH did not affect anatomical (P = 0.578) or functional (P = 0.381) outcome. Median follow-up was 31.5, 6.5, and 2.5 months in the three groups, respectively.
Conclusions:
Co- existing posterior segment conditions and duration of SMH may influence the choice of treatment modality and treatment outcomes. Pneumatic displacement with r-tPA and r-tPA assisted vitrectomy appear to be favorable options for the management of SMH.
Description
Keywords
Age-related macular degeneration, chorodial neovascularization, ocular trauma, polypoidal choroidal vasculopathy, retinal macroaneurysm, submacular hemorrhage, subretinal hemorrhage, tissue plasminogen activator, vitrectomy
Citation
Rishi Ekta, Gopal Lingam, Rishi Pukhraj, Sengupta Sabyasachi, Sharma Tarun. Submacular hemorrhage: A study amongst Indian eyes. Indian Journal of Ophthalmology. 2012 Nov-Dec; 60(6): 521-525.