Flattening of retinal pigment epithelial detachments after pneumatic displacement of submacular hemorrhages secondary to age-related macular degeneration
Flattening of retinal pigment epithelial detachments after pneumatic displacement of submacular hemorrhages secondary to age-related macular degeneration
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年龄相关性黄斑变性继发黄斑下出血气动移位后视网膜色素上皮脱离变平
DOI：
10.1007/s00417-018-4059-9
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发表时间：
2018
期刊：
影响因子：
--
通讯作者：
Ogura Yuichiro
中科院分区：
文献类型：
--
作者：
Kimura Masayo;Yasukawa Tsutomu;Shibata Yu;Kato Aki;Hirano Yoshio;Uemura Akiyoshi;Yoshida Munenori;Ogura Yuichiro
目的玻璃体内注射六氟化硫(SF6)气体联合或不联合组织纤溶酶原激活剂(TPA)和俯卧位治疗黄斑下出血(SMHS)是一种有效的微创治疗方法。我们观察到一些在俯卧位后同时发生出血性色素上皮脱离(PED)扁平的病例。本研究通过对32例(33只眼)新生血管性老年性黄斑变性(AMD)继发的SMHS患者行tPA充气置换治疗后的PED和视力结果进行回顾性分析。SMHS合并息肉状脉络膜血管病(PCV)24眼，典型AMD 9眼，玻璃体内注射SF6气体联合tPA治疗。评估术后最佳矫正视力(BCVA)、PED的患病率和扁平率，以及补充治疗的次数。结果平均随访35.4BCVA± 19.8个月。与典型的AMD相比，PCV患者的BCVA明显改善。33只眼中31只眼(93.9%)伴有PED。24眼PCV患者中14眼(58.3%)PED变平，而7眼典型AMD患者中仅1眼(14.3%)PED变平(p= 0.04)。平坦型PED患者15只眼在第一年平均增加一次治疗，显著少于16只持续性PED患者的3.6%(p<； 0.05)。使用tPA的SMHS气动置换意外地使PED变平，特别是在患有PCV的眼睛中，并且与较少的额外治疗有关。
PurposePneumatic displacement of submacular hemorrhages (SMHs) with intravitreal injection of sulfur hexafluoride (SF6) gas with or without tissue plasminogen activator (tPA) and prone posturing is an effective minimally invasive treatment. We observed some cases in which simultaneous flattening of hemorrhagic pigment epithelial detachments (PEDs) occurred after prone posturing. This study evaluated the impact of pneumatic displacement using tPA to treat PEDs and visual outcomes in eyes with SMHs secondary to neovascular age-related macular degeneration (AMD).MethodsThis retrospective analysis reviewed the medical records of 32 patients (33 eyes) who underwent pneumatic displacement for AMD-associated SMHs. The SMHs were related to polypoidal choroidal vasculopathy (PCV) in 24 eyes and typical AMD in nine eyes and treated with intravitreal injection of SF6gas with tPA. We assessed the postoperative best-corrected visual acuities (BCVAs), prevalence and flattening rates of the PEDs, and the number of additional treatments.ResultsThe mean follow-up period was 35.4 ± 19.8 months. The BCVAs improved significantly in eyes with PCV compared with eyes with typical AMD. Thirty-one (93.9%) of 33 eyes had an accompanying PED. The PEDs flattened in 14 (58.3%) of 24 eyes with PCV but in only one (14.3%) of seven eyes with typical AMD (p= 0.04). A mean of one additional treatment was administered during the first year in 15 eyes with flattened PEDs, which was significantly (p< 0.05) fewer than the 3.6 additional treatments in 16 eyes with persistent PEDs.ConclusionsPEDs often accompany SMHs secondary to neovascular AMD. Pneumatic displacement of the SMHs using tPA unexpectedly flattened the PEDs, especially in eyes with PCV, and was associated with fewer additional treatments.
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影响因子：
0.8
作者：
G. Matt;S. Sacu;E. Stifter;C. Prünte;U. Schmidt
通讯作者：
U. Schmidt
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影响因子：
3.4
作者：
Anna Tsymanava;C. Uhlig
通讯作者：
C. Uhlig
玻璃体切除术和视网膜下注射组织纤溶酶原激活剂治疗 AMD 继发的大黄斑下出血
影响因子：
1.7
作者：
E. Moisseiev;Tal Ben Ami;A. Barak
通讯作者：
A. Barak
玻璃体内 tPA 治疗黄斑下出血的更多经验
DOI：
--
发表时间：
1997
期刊：
影响因子：
--
作者：
W. Heriot
通讯作者：
W. Heriot
影响因子：
4.2
作者：
Yanyali, Ates;Aytug, Banu;Nohutcu, Ahmet F.
通讯作者：
Nohutcu, Ahmet F.