Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Tarmann, L.
23- gauge vitrectomy, intravitreal TPA, anti-VEGF and gas for the treatment of submacular hemorrhages due to age-related-macular-degeneration
[ Diplomarbeit ] Medical University of Graz; 2011. pp. 50
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- Autor*innen der Med Uni Graz:
- Vajda Lisa
- Betreuer*innen:
- Maier Richard
- Wedrich Andreas
- Altmetrics:
- Abstract:
- INTRODUCTION: Age related macular degeneration (ARMD) is a degenerative disease of the center of the retina and point of sharpest vision. A severe complication of ARMD, a submacular hemorrhage, is the leading cause of acute blindness in the western world. The following study was performed to evaluate the different course of visual recovery using a 23g- surgery system secondary to treat an acute occurring submacular hemorrhage in eyes with ARMD. MATERIAL AND METHODS: We performed a retrospective data analysis of 15 eyes (11 female, 4 male) with subretinal hemorrhages due to ARMD. Data was obtained from 15 patients, who underwent a 23g- pars plana vitrectomy, injection of recombinant tissue plasminogen activator (50µg) and gas (SF6, C2F6 or C3F8 gas/ gas-air mixture), as well as anti-VEGF (Avastin®) between 2007 and 2009 at the Department of Ophthalmology of the Medical University Graz. RESULTS: The age at the time of treatment ranged between 71 and 89 years, averaging 81.3 years. The visual acuity (V.A.) of the 15 treated patients preoperatively ranged from light perception to 20/40 Snellen and the duration of vision loss was at an average between 1 and 2 weeks. At ~1.5 months postoperative V.A. improved in 8 (53%) eyes, 6 (40%) eyes remained stable and 1 eye (7%) worsened. At ~2.9 months V.A. improved in 8 (53%) eyes, 5 (33%) eyes remained stable and 2 (14%) eyes worsened. The pneumatic displacement of the submacular hemorrhage was successful in 10 (67%) of 15 eyes. No association between duration or size of the hemorrhage and visual or anatomical outcome was found. The internal evaluation showed that 7 (47%) of 15 patients achieved anticoagulant medication, 11 (73%) patients suffered from arterial hypertension and 2 (13%) patients from diabetes mellitus Type II. CONCLUSION: The treatment of submacular hemorrhages with a 23g- surgery system, TPA, Bevacizumab and gas achieves good anatomical and functional results. The internal evaluation leads to the assumption that anticoagulant medication and arterial hypertension may contribute to subretinal bleeding in ARMD.