Combined treatment of submacular hemorrhage with low-dose subretinal recombinant tissue plasminogen activator and intravitreal conbercept.

IF 1.7 4区医学 Q3 OPHTHALMOLOGY

BMC Ophthalmology Pub Date : 2024-09-05 DOI:10.1186/s12886-024-03660-x

Yunxi Ma, Suyun Rao, Yuhe Tan, Hao Du, Xufang Sun

{"title":"Combined treatment of submacular hemorrhage with low-dose subretinal recombinant tissue plasminogen activator and intravitreal conbercept.","authors":"Yunxi Ma, Suyun Rao, Yuhe Tan, Hao Du, Xufang Sun","doi":"10.1186/s12886-024-03660-x","DOIUrl":null,"url":null,"abstract":"Background: Pars Plana Vitrectomy (PPV) combined with subretinal injection of low-dose recombinant tissue plasminogen activator (rt-PA) and intravitreal injection of Conbercept as a novel therapy for submacular hemorrhage (SMH) requires evaluation.Methods: In a retrospective interventional clinical study, 14 eyes of 14 patients with SMH underwent PPV along with rt-PA (subretinal) and Conbercept (intravitreal) injections. The main outcomes included best-corrected visual acuities (BCVAs), degrees of blood displacement, and adverse events. All patients completed at least 6-month follow-up visits.Results: Mean BCVAs significantly improved at 7 days (22.29 ± 15.35), 1 month (30.71 ± 16.42), 3 months (38.29 ± 13.72), 4 months (38.86 ± 14.15), and 6 months (41.21 ± 14.91) post-treatment compared to baseline (16.36 ± 13.97) (F = 12.89, P = 0.004). The peak improvement in BCVAs occurred at 6 months postoperatively. The procedure effectively eliminated subfoveal hemorrhages in all eyes, with clots removal and absorption occurring within one month and complete regression by 3-month follow-up visits. Postoperatively, two cases of AMD resulted in discoid scars on the fundus. No instances of rt-PA-related retinal toxicity were observed during the follow-up period.Conclusion: The combined approach of PPV with low-dose rt-PA and anti-VEGF shows promise in enhancing both vision and anatomical structure in SMH therapy. Individualized treatment plans tailored to the primary disease should be developed to optimize visual prognoses.Trial registration: Retrospectively registered No.ChiCTR2100053034. Registration date: 10/11/2021.","PeriodicalId":9058,"journal":{"name":"BMC Ophthalmology","volume":null,"pages":null},"PeriodicalIF":1.7000,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375938/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Ophthalmology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12886-024-03660-x","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OPHTHALMOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Pars Plana Vitrectomy (PPV) combined with subretinal injection of low-dose recombinant tissue plasminogen activator (rt-PA) and intravitreal injection of Conbercept as a novel therapy for submacular hemorrhage (SMH) requires evaluation.

Methods: In a retrospective interventional clinical study, 14 eyes of 14 patients with SMH underwent PPV along with rt-PA (subretinal) and Conbercept (intravitreal) injections. The main outcomes included best-corrected visual acuities (BCVAs), degrees of blood displacement, and adverse events. All patients completed at least 6-month follow-up visits.

Results: Mean BCVAs significantly improved at 7 days (22.29 ± 15.35), 1 month (30.71 ± 16.42), 3 months (38.29 ± 13.72), 4 months (38.86 ± 14.15), and 6 months (41.21 ± 14.91) post-treatment compared to baseline (16.36 ± 13.97) (F = 12.89, P = 0.004). The peak improvement in BCVAs occurred at 6 months postoperatively. The procedure effectively eliminated subfoveal hemorrhages in all eyes, with clots removal and absorption occurring within one month and complete regression by 3-month follow-up visits. Postoperatively, two cases of AMD resulted in discoid scars on the fundus. No instances of rt-PA-related retinal toxicity were observed during the follow-up period.

Conclusion: The combined approach of PPV with low-dose rt-PA and anti-VEGF shows promise in enhancing both vision and anatomical structure in SMH therapy. Individualized treatment plans tailored to the primary disease should be developed to optimize visual prognoses.

Trial registration: Retrospectively registered No.ChiCTR2100053034. Registration date: 10/11/2021.

查看原文本刊更多论文

用低剂量视网膜下重组组织浆蛋白酶原激活剂和玻璃体内康柏西普联合治疗玻璃体下出血。

背景：玻璃体旁切除术（PPV）联合低剂量重组组织浆蛋白酶原激活剂（rt-PA）视网膜下注射和康柏西普（Conbercept）玻璃体内注射作为治疗玻璃体下出血（SMH）的新疗法需要进行评估：在一项回顾性介入临床研究中，14名SMH患者的14只眼睛接受了PPV以及rt-PA（视网膜下）和康贝赛普（玻璃体内）注射。主要结果包括最佳矫正视力（BCVA）、血液移位程度和不良反应。所有患者均完成了至少6个月的随访：与基线（16.36 ± 13.97）相比，治疗后 7 天（22.29 ± 15.35）、1 个月（30.71 ± 16.42）、3 个月（38.29 ± 13.72）、4 个月（38.86 ± 14.15）和 6 个月（41.21 ± 14.91）的平均 BCVAs 均有明显改善（F = 12.89，P = 0.004）。BCVA改善的峰值出现在术后6个月。手术有效消除了所有眼的眼底出血，血块在一个月内被清除和吸收，并在三个月的随访中完全消退。术后，两例老年性黄斑变性患者的眼底出现了盘状疤痕。随访期间未发现与rt-PA相关的视网膜毒性：结论：在 SMH 治疗中，PPV 与低剂量 rt-PA 和抗血管内皮生长因子相结合的方法有望同时提高视力和改善解剖结构。结论：在 SMH 治疗中，PPV 与低剂量 rt-PA 和抗血管内皮生长因子联合疗法有望提高视力并改善解剖结构。应根据原发疾病制定个性化治疗方案，以优化视觉预后：注册号：ChiCTR2100053034。注册日期：2021年11月10日。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

BMC Ophthalmology OPHTHALMOLOGY-

CiteScore

3.40

自引率

5.00%

发文量

441

审稿时长

6-12 weeks

期刊介绍： BMC Ophthalmology is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of eye disorders, as well as related molecular genetics, pathophysiology, and epidemiology.