| |
DOG Congress Home
Invitation
Organization, Deadlines
Overview of the Congress
Scientific Programme
Opening Ceremony
Ceremony 150 Years of DOG
Thursday, 20.September
Friday, 21.September
Saturday, 22.September
Sunday, 23.September
Poster Sessions
Symposia
Courses
Satellite Programme
Information
Social Programme
Sponsors, Exhibitors
DOG Homepage
|
|
AbstractFR.13.02 Combined intravitreal injection of rt-PA, gas and anti-VEGF for management of major subfoveal haemorrhages secondary to neovascular age-related macular degeneration Sacu S., Schütze C., Stifter E., Michels S., Vécsei-Marlovits P., Prünte C., Schmidt-Erfurth U.
Department of Ophthalmology, Medical University of Vienna
Presenter: Prof. C. Prünte Objective: Subfoveal haemorrhage is a serious complication of neovascular age-related macular degeneration (AMD). The aim of this study is to evaluate the treatment effect of combination therapy of an intravitreal recombinant tissue plasminogen activator (rt-PA), gas, and anti-vascular endothelial growth factor (VEGF) for the management of major subfoveal haemorrhages.
Methods: In this prospective study, 20 eyes of 20 patents with recent (£14 days) major (4 to 10 disc areas) subfoveal haemorrhage secondary to AMD and severe visual loss were treated with intravitreous injections of rt-PA (50 µg in 0.1ml BSS) and sulphur hexafluoride (0.5 mm3) (11 female, 9 male, mean age of 74±8 year). The patient was positioned prone for 24 hours. An intravitreal injection of Bevacizumab (AvastinTM, 0,04 ml, 1 mg n=16) or Ranibizumab (LucentisTM 0.05 ml, n=4) was performed between day 1 and 3. The treatment effect was evaluated using distance visual acuity and optical coherence tomography (OCT) at baseline and at weeks 4, 8 and 12.
Results: At week 12, patients showed an improvement in mean VA of +1.5 lines (from logMar 1.4 to logMar 0.73, p=0.0009). In 7 of 9 eyes vision improved from visual acuity at 1 meter (n=4) or 0.05 snellen (n=4) visual acuity to 0.1-0.4. In 2 eyes (10%) visual acuity deteriorated more than 1 line. At week 12 the central retinal thickness was reduced by 94 µm (p=0.043). Four patients received a re-injection of anti-VEGF (at week 4; 2 patients, at weeks 8 and 12; each 1 patient). Postoperative complication was 1 case of vitreous haemorrhage.
Conclusions: In patients with a major subfoveal haemorrhage secondary to AMD, the combination therapy of rt-PA, gas and anti-VEGF allows rapidly improvement and stabilisation of visual acuity. The complication rate of this therapeutic approach seems to be low.
|
|
