Vitrectomy and Subretinal Injection of Tissue Plasminogen Activator for Large Submacular Hemorrhage Secondary to AMD
Vitrectomy and Subretinal Injection of Tissue Plasminogen Activator for Large Submacular Hemorrhage Secondary to AMD
复制标题
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
DOI：
10.5301/ejo.5000500
复制
发表时间：
2014
影响因子：
1.7
通讯作者：
A. Barak
中科院分区：
文献类型：
--
作者：
E. Moisseiev;Tal Ben Ami;A. Barak
目的评价玻璃体切割术（PPV）联合视网膜下注射组织型纤溶酶原激活剂（tPA）治疗老年性黄斑变性（AMD）继发黄斑下大出血（SMH）的疗效和安全性，并探讨与视力预后相关的参数。方法回顾性分析31例（31眼）因AMD继发的巨大SMH行PPV联合视网膜下tPA注射治疗的患者。主要结果测量是视力（VA）至少一行的改善。结果14例（45.2%）患者术后视力改善。这些患者在就诊时的VA显著差于未改善的患者（p = 0.05）。中心视网膜厚度和早期干预与最终视力预后无关。术后并发症包括视网膜脱离（19.3%）、复发性SMH（6.4%）和眼压升高（6.4%）。结论术前VA是与VA改善相关的最重要的术前参数。建议使用数指VA的临界值，因为就诊时VA较好的患者并没有从手术中获益。
Purpose To evaluate the efficacy and safety of pars plana vitrectomy (PPV) with subretinal injection of tissue plasminogen activator (tPA) for the treatment of large submacular hemorrhage (SMH) secondary to age-related macular degeneration (AMD), and identify parameters correlated with the visual prognosis. Methods Thirty-one eyes that underwent PPV with subretinal tPA injection for large SMH secondary to AMD were included in this retrospective study. Main outcome measure was improvement in at least one line in visual acuity (VA). Results Improvement in VA was achieved in 14 (45.2%) patients. These patients had a significantly worse VA at presentation than patients who did not improve (p = 0.05). Central retinal thickness and earlier intervention were not correlated with the final visual prognosis. Postoperative complications included retinal detachment (19.3%), recurrent SMH (6.4%), and elevated intraocular pressure (6.4%). Conclusions The VA at presentation is the most significant pre-operative parameter associated with improvement in VA. A cutoff value of counting fingers VA is suggested, as patients with better VA at presentation did not benefit from surgery.
影响因子：
4.2
作者：
GLATT, H;MACHEMER, R
通讯作者：
MACHEMER, R
影响因子：
13.7
作者：
Childs, AL;Bressler, NM;Miskala, PH
通讯作者：
Miskala, PH
影响因子：
13.7
作者：
Bressler, NM;Bressler, SB;Williams, GA
通讯作者：
Williams, GA