Intravitreal anti-vascular endothelial growth factor monotherapy for large submacular hemorrhage secondary to neovascular age-related macular degeneration.

Abstract

PURPOSE:

To evaluate the efficacy of anti-vascular endothelial growth factor (VEGF) monotherapy for large submacular hemorrhage (SMH) secondary to neovascular age-related macular degeneration (nAMD).

METHODS:

A total of 49 treatment-naive patients (49 eyes) with large SMH (more than five disc areas (DAs)) secondary to nAMD were retrospectively included. All patients were treated with an initial series of 3 monthly intravitreal anti-VEGF injections, followed by as-needed injections. At the 12-month follow-up, changes in best-corrected visual acuity (BCVA), hemorrhage area, central foveal thickness, and development of vitreous hemorrhage after treatment were evaluated.

RESULTS:

The mean SMH area was 13.9 ± 8.8 disk areas (DAs) and mean symptom duration was 7.25 ± 5.9 days at baseline. The mean number of injections was 4.49 ± 1.61. Twelve months after treatment, the mean BCVA significantly improved from 1.14 ± 0.61 logarithm of the minimum angle of resolution (logMAR; 20/276, Snellen equivalent) to 0.82 ± 0.53 logMAR (20/132; P = 0.002). Twenty-four eyes (49%) showed improvement of more than three lines of BCVA at 12 months after treatment. Baseline BCVA (odds ratio (OR), 5.119; 95% confidence interval (CI), 1.993-9.545; P = 0.004), duration of symptoms (OR, 0.727; 95% CI, 0.332-0.952; P = 0.024), hemorrhage area (OR, 0.892; 95% CI, 0.721-0.965; P = 0.011), and baseline central foveal thickness (OR, 0.881; 95% CI, 0.722-0.945; P = 0.032) were significantly associated with good visual acuity 12 months after treatment.

CONCLUSIONS:

Intravitreal anti-VEGF monotherapy is a valuable treatment option for large SMH secondary to nAMD.

• Authors: H S Kim, H J Cho, S G Yoo, J H Kim, J I Han, T G Lee, J W Kim
• Journal: Eye (London, England) (Eye (Lond)) Vol. 29 Issue 9 Pg. 1141-51 (Sep 2015) ISSN: 1476-5454 [Electronic] England
• PMID: 26272443 (Publication Type: Journal Article)

Chemical References

• Angiogenesis Inhibitors
• Antibodies, Monoclonal, Humanized
• Vascular Endothelial Growth Factor A
• Bevacizumab
• Ranibizumab

Topics

• Aged
• Aged, 80 and over
• Angiogenesis Inhibitors (administration & dosage)
• Antibodies, Monoclonal, Humanized (administration & dosage)
• Bevacizumab (administration & dosage)
• Female
• Fluorescein Angiography
• Humans
• Intravitreal Injections
• Macular Degeneration (complications, drug therapy)
• Male
• Middle Aged
• Ranibizumab (administration & dosage)
• Retinal Hemorrhage (drug therapy, etiology)
• Retrospective Studies
• Tomography, Optical Coherence
• Vascular Endothelial Growth Factor A (antagonists & inhibitors)
• Visual Acuity