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Anti-vascular endothelial growth factor with or without pneumatic displacement for submacular hemorrhage

 Joo Youn Shin  ;  Ji-min Lee  ;  Suk Ho Byeon 
 AMERICAN JOURNAL OF OPHTHALMOLOGY, Vol.159(5) : 904-914, 2015 
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Aged ; Angiogenesis Inhibitors/therapeutic use* ; Antibodies, Monoclonal, Humanized/therapeutic use ; Bevacizumab ; Combined Modality Therapy ; Endotamponade/methods* ; Female ; Fluorescein Angiography ; Fluorocarbons/administration & dosage ; Follow-Up Studies ; Humans ; Intravitreal Injections ; Male ; Ranibizumab ; Retinal Hemorrhage/etiology ; Retinal Hemorrhage/physiopathology ; Retinal Hemorrhage/therapy* ; Retrospective Studies ; Sulfur Hexafluoride/administration & dosage ; Tomography, Optical Coherence ; Vascular Endothelial Growth Factor A/antagonists & inhibitors* ; Visual Acuity/physiology ; Wet Macular Degeneration/complications ; Wet Macular Degeneration/drug therapy* ; Wet Macular Degeneration/physiopathology
PURPOSE: To compare the treatment outcomes of a combination of pneumatic displacement and intravitreal anti-vascular endothelial growth factor, and anti-vascular endothelial growth factor monotherapy for submacular hemorrhage resulting from exudative age-related macular degeneration. DESIGN: Retrospective, comparative, interventional case series. METHODS: Forty eyes treated with a combination therapy and 42 eyes treated with monotherapy for submacular hemorrhage resulting from exudative age-related macular degeneration with no significant difference in baseline central foveal thickness were compared. Central foveal thickness and best-corrected visual acuity (BCVA) at baseline, 1, 3, and 6 months after initial treatment were measured and compared between the 2 groups after adjustment of baseline central foveal thickness. RESULTS: Central foveal thickness (P < .0001) and BCVA (combination, P < .0001; monotherapy, P = .022) were improved after both treatments. Combination therapy showed more rapid improvement of central foveal thickness (P = .009) and BCVA (P = .007) within 1 month than monotherapy, but there was no difference at 6 months (P = .385 and P = .303, respectively). In eyes with subretinal hemorrhage thicker than 450 μm, visual outcome at 6 months was better in the combination therapy group than in the monotherapy group (P = .021), whereas BCVA showed no significant difference between groups in eyes with subretinal hemorrhage less than 450 μm (P = .930). CONCLUSIONS: Both treatments are useful options for submacular hemorrhage resulting from exudative age-related macular degeneration. Combination therapy may yield a better treatment outcome than monotherapy in eyes with thick subretinal hemorrhage. Nevertheless, the potential for adverse events resulting from pneumatic displacement should be considered.
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1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Byeon, Suk Ho(변석호) ORCID logo https://orcid.org/0000-0001-8101-0830
Shin, Joo Youn(신주연)
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