초기 치료로 유리체강내 조직플라스미노겐 활성제, C3F8 가스, 항혈관내피세포성장인자 주입술을 시행받은 대량망막하출혈 환자의 치료 후 임상 경과

Clinical Outcomes of Eyes with Massive Subretinal Hemorrhage Initially Treated with Intravitreal Injection of tPA, C3F8 Gas and Anti-VEGF

Purpose: To evaluate the clinical outcomes of eyes with massive subretinal hemorrhage (SRH) initially treated with intravitreal injection of tissue plasminogen activator (tPA), perfluoropropane (C3F8) gas and anti- vascular endothelial growth factor (anti-VEGF) (triple therapy). Methods: Twenty one eyes of 21 patients with massive SRH followed up for ≥ 3 months after triple therapy were retrospectively reviewed. The final diagnosis of patients, efficacy and clinical outcomes of the triple therapy were investigated. Results: The final diagnosis of 21 eyes consisted of three disease. 13 eyes (61.9%) were polypoidal choroidal vasculopathy, 4 eyes (19.0%) were age-related macular degeneration, 2 eyes (9.5%) were retinal macroaneurysm and 2 eyes (9.5%) could not be confirmed the final diagnosis. The mean size of SRH was 4.5 (±1.5) disc diameter. The visual acuity was improved in 10 eyes (47.6%), remained stable in 10 eyes (47.6%) and decreased in 1 eye (4.8%). The size of SRH and final diagnosis had not significant relationship on visual acuity change. For 12 eyes followed up for ≥ 12 months after triple therapy, the mean logMAR best-corrected visual acuity significantly improved at 12 months (p=0.023, Wilcoxon signed rank test). Conclusions: The triple therapy of tPA, C3F8 gas and anti-VEGF could be a one of effective initial treatment modality in stabilization and maintenance of visual improvement for massive SRH.