Background To evaluate the outcomes of three-dimensional(3D)heads-up system assisted pars plana vitrectomy(PPV)and subretinal injection of recombinant tissue plasminogen activator(rt-PA)for submacular hemorrhage(SMH)....Background To evaluate the outcomes of three-dimensional(3D)heads-up system assisted pars plana vitrectomy(PPV)and subretinal injection of recombinant tissue plasminogen activator(rt-PA)for submacular hemorrhage(SMH).Methods Medical records of SMH patients who underwent 3D heads-up system assisted-PPV and subretinal injection of rt-PA from June 2021 to January 2022 were reviewed.The main outcomes included best-corrected visual acuity(BCVA),SMH absorption,and perioperative complications.Results We fnally included 18 SMH eyes,most of which happened secondary to polypoidal choroidal vasculopathy(PCV)(10,55.56%),followed by retinal arterial microaneurysm(RAM)(5,27.78%),traumatic retinopathy(2,11.11%)and neovascular age-related macular degeneration(nAMD)(1,5.56%).The greatest linear dimension(GLD)and height of SMH were 6538.17±2533.11μm and 937.36±420.21μm,respectively.After an average postoperative follow-up period of 131.06±38.96 days,patients’BCVA improved signifcantly from 1.85±0.62 to 1.14±0.82 logMAR(P<0.05).SMH was completely and partially absorbed in 9(50.00%)and 6(33.33%)eyes,with no occurrence of iatrogenic retinal break.However,4 additional PPVs were performed to manage the postoperative SMH and/or vitreous hemorrhage(VH)recurrence(2,11.11%)and retinal detachment(RD)occurrence(2,11.11%).Preoperative BCVA was signifcantly correlated with postoperative BCVA in multiple linear regression analysis(P<0.05),and hemorrhagic pigment epithelial detachment(PED)was signifcantly correlated with SMH and VH recurrence in univariate binary logistic regression analysis(P<0.05).Conclusions The 3D heads-up system assisted-PPV and subretinal injection of rt-PA were efcacious in eliminating SMH and improving visual prognosis with satisfactory safety profle,while caution should be taken for PCV patients with hemorrhagic PED and massive SMH.展开更多
文摘Background To evaluate the outcomes of three-dimensional(3D)heads-up system assisted pars plana vitrectomy(PPV)and subretinal injection of recombinant tissue plasminogen activator(rt-PA)for submacular hemorrhage(SMH).Methods Medical records of SMH patients who underwent 3D heads-up system assisted-PPV and subretinal injection of rt-PA from June 2021 to January 2022 were reviewed.The main outcomes included best-corrected visual acuity(BCVA),SMH absorption,and perioperative complications.Results We fnally included 18 SMH eyes,most of which happened secondary to polypoidal choroidal vasculopathy(PCV)(10,55.56%),followed by retinal arterial microaneurysm(RAM)(5,27.78%),traumatic retinopathy(2,11.11%)and neovascular age-related macular degeneration(nAMD)(1,5.56%).The greatest linear dimension(GLD)and height of SMH were 6538.17±2533.11μm and 937.36±420.21μm,respectively.After an average postoperative follow-up period of 131.06±38.96 days,patients’BCVA improved signifcantly from 1.85±0.62 to 1.14±0.82 logMAR(P<0.05).SMH was completely and partially absorbed in 9(50.00%)and 6(33.33%)eyes,with no occurrence of iatrogenic retinal break.However,4 additional PPVs were performed to manage the postoperative SMH and/or vitreous hemorrhage(VH)recurrence(2,11.11%)and retinal detachment(RD)occurrence(2,11.11%).Preoperative BCVA was signifcantly correlated with postoperative BCVA in multiple linear regression analysis(P<0.05),and hemorrhagic pigment epithelial detachment(PED)was signifcantly correlated with SMH and VH recurrence in univariate binary logistic regression analysis(P<0.05).Conclusions The 3D heads-up system assisted-PPV and subretinal injection of rt-PA were efcacious in eliminating SMH and improving visual prognosis with satisfactory safety profle,while caution should be taken for PCV patients with hemorrhagic PED and massive SMH.
