Grohmann Carsten, Dimopoulos Spyridon, Bartz-Schmidt Karl Ulrich, Schindler Philipp, Katz Toam, Spitzer Martin S, Skevas Christos
Department of Ophthalmology, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany.
Department of Ophthalmology, Eberhard Karls University Medical Center, Tübingen, Germany.
Int J Retina Vitreous. 2020 Jul 2;6:27. doi: 10.1186/s40942-020-00228-x. eCollection 2020.
To compare and assess the efficacy of three surgical methods for the treatment of acute submacular hemorrhage (ASH): pneumatic displacement with C2F6, in combination with intravitreal injection of bevacizumab and rtPA, pars plana vitrectomy (PPV) with intravitreal injection of gas (C2F6), bevacizumab and subretinal injection of recombinant tissue plasminogen activator (rtPA), pars plana vitrectomy (PPV) with intravitreal injection of gas (C2F6), bevacizumab and intravitreal injection of recombinant tissue plasminogen activator (rtPA).
The study included 85 patients with ASH. In the group without PPV (A), patients were treated with intravitreal injection of C2F6, bevacizumab and rtPA. In the second and third group, patients underwent a PPV, intravitreal injection of bevacizumab, pneumatic displacement with C2F6 and a subretinal (B) or intravitreal (C) injection of recombinant tissue plasminogen activator (rt PA).
In group A, mean BCVA increased from preop logMAR 1.41 to 1.05, in group B from 1.46 to 1.28 and in group C from 1.63 to 1.33. In group A, CFT changed from 764 ± 340 μm at time point 0 to 246 ± 153 μm at time point 1, in group B from 987 ± 441 μm to 294 ± 166 μm and in group C from 642 ± 322 μm to 418 ± 364 μm. Patients had an average of 5 injections after surgery.
Our study demonstrates that the three methods are equally effective in improving the morphology and the BCVA of patients with ASH.
比较和评估三种手术方法治疗急性黄斑下出血（ASH）的疗效：使用六氟乙烷（C2F6）进行气体置换，并联合玻璃体内注射贝伐单抗和重组组织型纤溶酶原激活剂（rtPA）；经平坦部玻璃体切除术（PPV）联合玻璃体内注射气体（C2F6）、贝伐单抗及视网膜下注射重组组织型纤溶酶原激活剂（rtPA）；经平坦部玻璃体切除术（PPV）联合玻璃体内注射气体（C2F6）、贝伐单抗及玻璃体内注射重组组织型纤溶酶原激活剂（rtPA）。
该研究纳入85例急性黄斑下出血患者。在非PPV组（A组），患者接受玻璃体内注射C2F6、贝伐单抗和rtPA治疗。在第二组和第三组，患者接受PPV、玻璃体内注射贝伐单抗、使用C2F6进行气体置换以及视网膜下（B组）或玻璃体内（C组）注射重组组织型纤溶酶原激活剂（rtPA）。
A组平均最佳矫正视力（BCVA）从术前的LogMAR 1.41提高到1.05，B组从1.46提高到1.28，C组从1.63提高到1.33。A组中心凹视网膜厚度（CFT）在时间点0时为764±340μm，在时间点1时变为246±153μm；B组从987±441μm变为294±166μm；C组从642±322μm变为418±364μm。患者术后平均注射5次。
我们的研究表明，这三种方法在改善急性黄斑下出血患者的形态和最佳矫正视力方面同样有效。
