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목적 : The aim of this study was to report the visual outcome of a vitrectomy with simultaneous subretinal bevacizumab and recombinant tissue plasminogen activator (rt-PA) for a subretinal hemorrhage that was secondary to age related macular degeneration (AMD).
방법 : Five patients with a subretinal hemorrhage secondary to AMD were treated by vitrectomy, 1.25mg subretinal bevacizumab and 10μg rt-PA injection, fluid-air exchange and 14% perfluoropropane (C3F8) gas injection. The best corrected visual acuity, retinal thickness determined by ocular coherence tomography, a fluorescein angiography, an indocyanine green angiography and a multifocal electroretinogram were evaluated at baseline and at 1, 3, and 6 months after the operation.
결과 : The subretinal hemorrhages were significantly reduced in all patients. Preoprerative mean BCVA was 0.15±0.21 by Snellen and changed to 0.17±0.27 after 6 months without significant difference(P=0.285). Preoperative average central macular thickness was 386±189.4µm and was reduced to 201.5±86.0 µm not showing significant change(P=0.144). The mean P1 amplitude decreased from 38.5±14.9 to 20.7±18.0nV/deg2 with statistically significant change(P=0.043). Two eyes demonstrated extensive subretinal fibrosis, and one demonstrated atrophy of the RPE which limited the visual outcomes.
결론 : The visual outcome of a vitrectomy with subretinal bevacizumab is poor due to the progression of subretinal fibrosis and RPE atrophy. Therefore subretinal bevacizumab should be avoided instead of standard intravitreal injection.
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