Three-dimensional heads-up system assisted pars plana vitrectomy and subretinal recombinant tissue plasminogen activator injection for submacular hemorrhage  

作　　者：Xinyu Zhao Qing Zhao Erqian Wang Ningning Li Lihui Meng Wenfei Zhang Tan Wang Youxin Chen Hanyi Min 

机构地区：[1]Department of Ophthalmology,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,No.1 Shuaifuyuan,Wangfujing,Dongcheng District,Beijing 100730,China [2]Key Laboratory of Ocular Fundus Diseases,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing,China [3]Department of Operating Room,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences,Beijing,China.

出　　处：《Eye and Vision》2025年第1期22-32,共11页眼视光学杂志(英文)

摘　　要：Background To evaluate the outcomes of three-dimensional(3D)heads-up system assisted pars plana vitrectomy(PPV)and subretinal injection of recombinant tissue plasminogen activator(rt-PA)for submacular hemorrhage(SMH).Methods Medical records of SMH patients who underwent 3D heads-up system assisted-PPV and subretinal injection of rt-PA from June 2021 to January 2022 were reviewed.The main outcomes included best-corrected visual acuity(BCVA),SMH absorption,and perioperative complications.Results We fnally included 18 SMH eyes,most of which happened secondary to polypoidal choroidal vasculopathy(PCV)(10,55.56%),followed by retinal arterial microaneurysm(RAM)(5,27.78%),traumatic retinopathy(2,11.11%)and neovascular age-related macular degeneration(nAMD)(1,5.56%).The greatest linear dimension(GLD)and height of SMH were 6538.17±2533.11μm and 937.36±420.21μm,respectively.After an average postoperative follow-up period of 131.06±38.96 days,patients’BCVA improved signifcantly from 1.85±0.62 to 1.14±0.82 logMAR(P<0.05).SMH was completely and partially absorbed in 9(50.00%)and 6(33.33%)eyes,with no occurrence of iatrogenic retinal break.However,4 additional PPVs were performed to manage the postoperative SMH and/or vitreous hemorrhage(VH)recurrence(2,11.11%)and retinal detachment(RD)occurrence(2,11.11%).Preoperative BCVA was signifcantly correlated with postoperative BCVA in multiple linear regression analysis(P<0.05),and hemorrhagic pigment epithelial detachment(PED)was signifcantly correlated with SMH and VH recurrence in univariate binary logistic regression analysis(P<0.05).Conclusions The 3D heads-up system assisted-PPV and subretinal injection of rt-PA were efcacious in eliminating SMH and improving visual prognosis with satisfactory safety profle,while caution should be taken for PCV patients with hemorrhagic PED and massive SMH.

关 键 词：Submacular hemorrhage Three-dimensional heads-up system Recombinant tissue plasminogen activator Safety Efcacy 

分 类 号：R74[医药卫生—神经病学与精神病学]