Surgical treatment of extensive submacular hemorrhage in patient with exudative age-related macular degeneration (clinical case)

2021 ◽  
pp. 144-146
Author(s):  
V.A. Rudenko ◽  
Keyword(s):  
Visual Acuity ◽  
Surgical Treatment ◽  
Macular Degeneration ◽  
Clinical Case ◽  
Blood Clot ◽  
Age Related Macular Degeneration ◽  
Submacular Hemorrhage ◽  
Age Related ◽  
Subretinal Neovascular Membrane ◽  
Subretinal Injection

Purpose. To evaluate the result of surgical treatment of submacular hemorrhage in patient with exudative age-related macular degeneration (AMD) by subretinal injection Gemase® and pneumatic retinopexy of blood clot. Material and methods. The article presents a clinical case of surgical treatment of submacular hemorrhage in patient with exudative AMD. The patient underwent three-port 25G vitrectomy, subretinal injection Gemase® 2000 ME by 38G needle, after which pneumatic retinopexy was performed. Results. Next day after the operation, there was displacement of subretinal blood clot from macula beyond out the lower vascular arcade. When observed after 6 months, the subretinal hemorrhage completely resolved, there was a regression of activity of subretinal neovascular membrane and macular edema, the retina was adherent in all cases. Visual acuity has improved. There was no recurrence of hemorrhage. Conclusion. This method of treatment allows you to increase and maintain the central visual acuity, as well as significantly reduce size of absolute central scotoma. Key words: submacular hemorrhage, recombinant prourokinase, Gemase®, exudative age-related macular degeneration, choroidal neovascularization, subretinal neovascular membrane.

scholarly journals Autologous Plasma Enriched with Platelet Lysate for the Treatment of Idiopathic Age-Related Macular Degeneration: A Prospective Study

2018 ◽  
Vol 73 (1) ◽  
pp. 40-48
Author(s):  
A. P. Lykov ◽  
O. V. Poveshchenk ◽  
M. A. Surovtseva ◽  
O. M. Stanishevskaya ◽  
D. V. Chernykh ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Growth Factors ◽  
Surgical Treatment ◽  
Macular Degeneration ◽  
Clinical Efficacy ◽  
Early Postoperative Period ◽  
Platelet Lysate ◽  
Age Related Macular Degeneration ◽  
Autologous Plasma ◽  
Age Related

Background: Plasma enriched in growth factors is widely used in medical practice. However, the clinical efficacy of its application in the treatment of age-related retinal integrity violations is investigated insufficiently. Aims: The aim of the study was to evaluate the clinical efficacy of autologous plasma enriched with platelet lysate for treating age-related macular degeneration. Materials and methods: A three-port subtotal transconjunctival vitrectomy was performed and administration of the autologous plasma enriched with platelet lysate was indicated. Autologous plasma enriched with platelet lysate was received from the peripheral blood. We assessed visual acuity, intraocular pressure; conducted optical coherent tomography examination of the eye on the side of the pathological process. Results: The study demonstrated that the combination of a standard 3-port transconjunctival subtotal vitrectomy followed by tamponade of the gap using the autologous plasma enriched with platelet lysate with the injections of the autologous plasma enriched with platelet lysate in the area of pterygopalatine fossa on the side of the operated eyes statistically significantly promoted recovery of the visual acuity in the early postoperative period (15 days) and late period (90 days) if compared with patients who received only surgical treatment (p≤0.05). Use of the autologous plasma enriched with platelet lysate in the treatment increased the closing rate of the tearing of the retina in the macular region up to 62,5%, while only surgical treatment leads to the closure of the defect of the retina in 37.5% of cases. The study showed that autologous plasma enriched with platelet lysate contains cytokines, growth factors, and nitric oxide which are involved in the regeneration/reparation of the retina. Conclusions: Additional administration of the autologous plasma enriched with platelet lysate in the scheme of treatment patients with age-related macular degeneration is accelerating the closure of retinal tears of the eye and improves visual acuity.

scholarly journals The surgical treatment of massive submacular hemorrhages aggravating the course of exudative form of AMD with automated subretinal injection.

2020 ◽  
pp. 43-49
Author(s):  
A.D. Ovchinnikova ◽  
◽  
A.V. Mironov ◽  
T.O. Dulgieru ◽  
◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Intravitreal Injection ◽  
Blood Clot ◽  
Intraoperative Complications ◽  
Age Related Macular Degeneration ◽  
Subretinal Hemorrhage ◽  
Exudative Amd ◽  
Average Value ◽  
Age Related ◽  
Subretinal Injection

Purpose. The purpose of the study was to assess the results of the proposed method of surgical treatment of massive subretinal macular hemorrhage in the wet form of age-related macular degeneration. Material and methods. A comparative study of the results of treatment of massive subretinal hemorrhage associated with the exudative AMD-related. 17 patients (17 eyes) were being observed in the clinic with submacular hemorrhages of varying severity, which occurred against the background of exudative AMD-related. The average age of the subjects was 71.47±6.15 years. The maximum corrected visual acuity at the time of admission averaged 0,04±0.03. All patients were previously treated with anti-VEGF therapy, and number intravitreal injections was in the range from 3 to 14. The experience of the disease was 2,35±0,77 years, the prescription of hemorrhage – 5,47±3,55 days. The mean size of the subretinal hemorrhage was 21.41±3.37 DD. According to optical coherence tomography, the average value of retinal thickness in the macular region was 1081,29±389,67 microns. The day before surgery all patients underwent surgical treatment according to the author's method (patent No. 2696056) – intravitreal injection Gemase® 3000 ME, 0,2 ml. The next day was performed vitrectomy 25G, local removal of the ILM and subretinal injection Gemase® 3000 ME – 0.3 ml and 0.2 ml of sterile air, fluid-air exchange 70% of the volume vitreal cavity, intravitreal injection Eylea® 0.05 ml, tamponade of vitreous cavity with 20% SF6. After the operation, the patient was placed «horizontally on the back» for 2 hours, then he had to be in an upright position to move the blood clot to the lower parts of the ocular floor. Results. Intraoperative complications were not observed in any of the cases. A complete dislocation of subretinal hemorrhage from under fovea zone was achieved in every patient's postoperative period. Conclusion. The proposed surgical method provides rapid recovery of subject vision and can be used in the treatment of massive submacular hemorrhages of any etiology. Key words: AMD, submacular hemorrhages, vitrectomy, prourokinase.

scholarly journals Genetic biomarkers in the VEGF pathway predicting response to anti-VEGF therapy in age-related macular degeneration

2019 ◽  
Vol 4 (1) ◽  
pp. e000273
Author(s):  
Irina Balikova ◽  
Laurence Postelmans ◽  
Brigitte Pasteels ◽  
Pascale Coquelet ◽  
Janet Catherine ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Treatment Response ◽  
Multiple Testing ◽  
Age Related Macular Degeneration ◽  
Patient Specific ◽  
Multiple Testing Correction ◽  
Anti Vegf ◽  
Age Related ◽  
Vegf Pathway

ObjectiveAge-related macular degeneration (ARMD) is a leading cause of visual impairment. Intravitreal injections of anti-vascular endothelial growth factor (VEGF) are the standard treatment for wet ARMD. There is however, variability in patient responses, suggesting patient-specific factors influencing drug efficacy. We tested whether single nucleotide polymorphisms (SNPs) in genes encoding VEGF pathway members contribute to therapy response.Methods and analysisA retrospective cohort of 281 European wet ARMD patients treated with anti-VEGF was genotyped for 138 tagging SNPs in the VEGF pathway. Per patient, we collected best corrected visual acuity at baseline, after three loading injections and at 12 months. We also registered the injection number and changes in retinal morphology after three loading injections (central foveal thickness (CFT), intraretinal cysts and serous neuroepithelium detachment). Changes in CFT after 3 months were our primary outcome measure. Association of SNPs to response was assessed by binomial logistic regression. Replication was attempted by associating visual acuity changes to genotypes in an independent Japanese cohort.ResultsAssociation with treatment response was detected for seven SNPs, including in FLT4 (rs55667289: OR=0.746, 95% CI 0.63 to 0.88, p=0.0005) and KDR (rs7691507: OR=1.056, 95% CI 1.02 to 1.10, p=0.005; and rs2305945: OR=0.963, 95% CI 0.93 to 1.00, p=0.0472). Only association with rs55667289 in FLT4 survived multiple testing correction. This SNP was unavailable for testing in the replication cohort. Of six SNPs tested for replication, one was significant although not after multiple testing correction.ConclusionIdentifying genetic variants that define treatment response can help to develop individualised therapeutic approaches for wet ARMD patients and may point towards new targets in non-responders.

Association between retinal thickness variation and visual acuity change in neovascular age‐related macular degeneration

2021 ◽  
Author(s):  
Kai Xiong Cheong ◽  
Alvin Wei Jun Teo ◽  
Chui Ming Gemmy Cheung ◽  
Issac Horng Khit Too ◽  
Usha Chakravarthy ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Retinal Thickness ◽  
Age Related Macular Degeneration ◽  
Thickness Variation ◽  
Age Related

scholarly journals Neovascular age-related macular degeneration: is it worthwhile treating an eye with poor visual acuity, if the visual acuity of the fellow eye is good?

Eye ◽  
2017 ◽  
Vol 31 (6) ◽  
pp. 978-980 ◽  
Author(s):  
A Rasmussen ◽  
J Fuchs ◽  
L H Hansen ◽  
M Larsen ◽  
B Sander ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Macular Degeneration ◽  
Age Related Macular Degeneration ◽  
Fellow Eye ◽  
Age Related
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