Варианты антиангиогенной терапия субретинальных кровоизлияний на фоне возрастной макулодистрофии

Abstract

Purpose. To evaluate the effectiveness of various options for anti-angiogenic therapy in patients with subretinal hemorrhage (SRH) by of age-related macular degeneration (AMD). Material and methods. A total of 15 patients (15 eyes) with SRH by of AMD were treated. The mean duration of a hemorrhage from its onset to the start of treatment was 18.8 ± 10.0 days. The size of the SRH varied from 0.5 to 5 DD. The best corrected visual acuity (BCVA) before treatment varied from hand movement near the face to 0.1. Patients underwent the following treatment options for SRH: 1) anti-VEGF intravitreal injection (IVI) – 8 (53.3%); 2) IVI anti-VEGF + IVI prourokinase + IVI ophthalmic gas (SF6, C2F6) – 7 (46.7%). The average follow-up period for patients after treatment was 10.8 ± 6.3 months. Results and discussion. With the maximum follow-up period after the treatment in 2nd group it was possible to achieve hemorrhage displacement: partial – in 2 (58%) patients, complete – in 5 (71.5%) patients. At the maximum follow-up period, an improvement in BCVA in comparison with the preoperative one was observed in 8 (53.3%) cases, no dynamics – in 4 (26.7%) cases, and negative dynamics – in 3 (20%) cases. All patients underwent anti-VEGF therapy after the start of SRH treatment. Conclusions. The data obtained indicate that the use of antiangiogenic therapy of SRH by of AMD has positive results in improving BCVA and reducing the volume of hemorrhage. The choice of treatment method is determined by the size and duration of the existence of the SRH. It is necessary to continue anti-VEGF therapy in all patients after the start of treatment with SRH by of AMD. Keywords: submacular hemorrhage, age-related macular degeneration, pneumodislocation, anti-VEGF inhibitors, tissue plasminogen activator