Macular hemorrhage – therapy Review article

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Published: Mar 31, 2023
DOI: https://doi.org/10.24292/01.OT.220323.5
Keywords:
submacular hemorrhage, pneumatic displacement, anti-VEGF, rtPA, vitrectomy

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Małgorzata Gawlak
Wydział Lekarski i Nauk o Zdrowiu, Krakowska Akademia im. Andrzeja Frycza Modrzewskiego
http://orcid.org/0000-0003-4573-1379
Katarzyna Guzek
Wydział Lekarski i Nauk o Zdrowiu, Krakowska Akademia im. Andrzeja Frycza Modrzewskiego
http://orcid.org/0000-0003-1790-8667
Bartosz Kuźlik
Wydział Lekarski i Nauk o Zdrowiu, Krakowska Akademia im. Andrzeja Frycza Modrzewskiego
Ada Pandey
Wydział Lekarski i Nauk o Zdrowiu, Krakowska Akademia im. Andrzeja Frycza Modrzewskiego
http://orcid.org/0000-0001-9467-1005
Dominika Prokop
Wydział Lekarski i Nauk o Zdrowiu, Krakowska Akademia im. Andrzeja Frycza Modrzewskiego
http://orcid.org/0000-0001-7318-7716
Oliwia Cwalina
Wydział Lekarski i Nauk o Zdrowiu, Krakowska Akademia im. Andrzeja Frycza Modrzewskiego
http://orcid.org/0000-0002-7071-0273
Kinga Czarnacka
Wydział Lekarski i Nauk o Zdrowiu, Krakowska Akademia im. Andrzeja Frycza Modrzewskiego
http://orcid.org/0000-0002-6889-6507
Alicja Chmura-Hołyst
Wydział Lekarski i Nauk o Zdrowiu, Krakowska Akademia im. Andrzeja Frycza Modrzewskiego
http://orcid.org/0000-0003-0733-1542
Isamel Alsoubie
Wydział Lekarski i Nauk o Zdrowiu, Krakowska Akademia im. Andrzeja Frycza Modrzewskiego
http://orcid.org/0000-0002-0974-3025
Katarzyna Sajak-Hydzik
1. Wydział Lekarski i Nauk o Zdrowiu, Krakowska Akademia im. Andrzeja Frycza Modrzewskiego. 2. Katedra Okulistyki, Krakowska Akademia im. Andrzeja Frycza Modrzewskiego
http://orcid.org/0000-0002-1973-2717
Ilona Pawlicka
1. Wydział Lekarski i Nauk o Zdrowiu, Krakowska Akademia im. Andrzeja Frycza Modrzewskiego. 2. Katedra Okulistyki, Krakowska Akademia im. Andrzeja Frycza Modrzewskiego
Agnieszka Piskorz
1. Wydział Lekarski i Nauk o Zdrowiu, Krakowska Akademia im. Andrzeja Frycza Modrzewskiego. 2. Katedra Okulistyki, Krakowska Akademia im. Andrzeja Frycza Modrzewskiego
https://orcid.org/0000-0003-4553-0497
Maciej Kozak
1. Wydział Lekarski i Nauk o Zdrowiu, Krakowska Akademia im. Andrzeja Frycza Modrzewskiego. 2. Katedra Okulistyki, Krakowska Akademia im. Andrzeja Frycza Modrzewskiego
http://orcid.org/0000-0001-7993-2588
Anna Roszkowska
Katedra Okulistyki, Krakowska Akademia im. Andrzeja Frycza Modrzewskiego
https://orcid.org/0000-0002-8083-3437

Abstract

Submacular hemorrhage treatment is still an important issue in ophthalmology. At present we lack algorithms of treatment that could be used in clinical practice. Efficacy of every treatment method seems to differ by individual factors simultaneously existing in each patient. Therefore, anti-VEGF agents remain crucial in treating patients with coexisting vasculopathy, while in posttraumatic hemorrhage we should lean towards other approaches, like pneumatic displacement. Operative methods, despite being more invasive and burdened with higher potential risk, are indispensable in large hemorrhages, significantly speeding up clot removal. The primary aim of this work is to collect recent data regarding this issue and to determine usefulness of treatment methods in specific cases, regarding factors such as hemorrhage pathophysiology. The following article pertains to currently used treatment methods, such as: pneumatic displacement, anti-VEGF therapy, rtPA and operative methods.

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How to Cite
1.
Gawlak M, Guzek K, Kuźlik B, Pandey A, Prokop D, Cwalina O, Czarnacka K, Chmura-Hołyst A, Alsoubie I, Sajak-Hydzik K, Pawlicka I, Piskorz A, Kozak M, Roszkowska A. Macular hemorrhage – therapy. Ophthatherapy [Internet]. 2023Mar.31 [cited 2024Dec.22];10(1):57-2. Available from: https://journalsmededu.pl/index.php/ophthatherapy/article/view/2701
Issue
Vol 10 No 1 (2023)
Section
Conservative treatment
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Copyright: © Medical Education sp. z o.o. License allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.

Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)

References

1. Pierre M, Mainguy A, Chatziralli I et al. Macular Hemorrhage Due to Age-Related Macular Degeneration or Retinal Arterial Macroaneurysm: Predictive Factors of Surgical Outcome. J Clin Med. 2021; 10(24): 5787.
2. Gujral GS, Agarwal M, Mayor R et al. Clinical profile and management outcomes of traumatic submacular hemorrhage. J Curr Ophthalmol. 2019; 31(4): 411-5.
3. Chen CY, Hooper C, Chiu D et al. Management of submacular hemorrhage with intravitreal injection of tissue plasminogen activator and expansile gas. Retina. 2007; 27: 321-8.
4. Holland D, Wiechens B. Intravitreal r-TPA and gas injection in traumatic submacular hemorrhage. Ophthalmologica. 2004; 218: 64-9.
5. Gopalakrishan M, Giridhar A, Bhat S et al. Pneumatic displacement of submacular hemorrhage: safety, efficacy, and patient selection. Retina. 2007; 27: 329-34.
6. Ohji M, Saito Y, Hayashi A et al. Pneumatic displacement of subretinal hemorrhage without tissue plasminogen activator. Arch Ophthalmol. 1998; 116: 1326-32.
7. Balughatta P, Kadri V, Braganza S et al. Pneumatic displacement of limited traumatic submacular hemorrhage without tissue plasminogen activator: a case series. Retin Cases Brief Rep. 2019; 13: 34-8.
8. Casini G, Loiudice P, Menchini M et al. Traumatic submacular hemorrhage: available treatment options and synthesis of the literature. Int J Retin Vitr. 2019; 5: 48.
9. Vaidyanathan U, Moshirfar M. Ranibizumab. [Updated 2022 May 23]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan.
10. Sachdeva MM, Moshiri A, Leder HA et al. Endophthalmitis following intravitreal injection of anti-VEGF agents: long-term outcomes and the identification of unusual micro-organisms. J Ophthalmic Inflamm Infect. 2016; 6(1): 2. http://doi.org/10.1186/s12348-015-0069-5.
11. Neves da Silva HV, Placide J, Duong A et al. Ocular adverse effects of therapeutic biologics. Ther Adv Ophthalmol. 2022; 14: 25158414211070878. http://doi.org/10.1177/25158414211070878.
12. Shin YI, Sung JY, Sagong M et al. Risk factors for breakthrough vitreous hemorrhage after intravitreal anti-VEGF injection in age-related macular degeneration with submacular hemorrhage. Sci Rep. 2018; 8(1): 10560. http://doi.org/10.1038/s41598-018-28938-1.
13. Hussain RM, Neal A, Yannuzzi NA et al. Brolucizumab for persistent macular fluid in neovascular age-related macular degeneration after prior anti-VEGF treatments. Ther Adv Ophthalmol. 2021; 13: 25158414211055964. http://doi.org/10.1177/25158414211055964.
14. Chang AA, Li H, Broadhead GK et al. Intravitreal aflibercept for treatment-resistant neovascular age-related macular degeneration. Ophthalmology. 2014; 121(1): 188-92. http://doi.org/10.1016/j.ophtha.2013.08.035.
15. Pham B, Thomas SM, Lillie E et al. Anti-vascular endothelial growth factor treatment for retinal conditions: a systematic review and meta-analysis. BMJ Open. 2019; 9(5): e022031. http://doi.org/10.1136/bmjopen-2018-022031.
16. Edington M, Connolly J, Chong NV. Pharmacokinetics of intravitreal anti-VEGF drugs in vitrectomized versus non-vitrectomized eyes. Expert Opin Drug Metab Toxicol. 2017; 13(12): 1217-24. http://doi.org/10.1080/17425255.2017.1404987.
17. Nguyen, Quan Dong et al. Brolucizumab: Evolution through Preclinical and Clinical Studies and the Implications for the Management of Neovascular Age-Related Macular Degeneration. Ophthalmology. 2020; 127(7): 963-76.
18. Mun Y, Park KH, Park SJ et al. Comparison of treatment methods for submacular hemorrhage in neovascular age-related macular degeneration: conservative versus active surgical strategy. Sci Rep. 2022; 12(1): 14875. http://doi.org/10.1038/s41598-022-18619-5.
19. Shin JY, Lee JM, Byeon SH. Anti-vascular endothelial growth factor with or without pneumatic displacement for submacular hemorrhage. Am J Ophthalmol. 2015; 159(5): 904-14.e1. http://doi.org/10.1016/j.ajo.2015.01.024.
20. Caporossi T, Bacherini D, Governatori L et al. Management of submacular massive haemorrhage in age‐related macular degeneration: comparison between subretinal transplant of human amniotic membrane and subretinal injection of tissue plasminogen activator. Acta Ophthalmologica. 2022; 100(5): e1143-e1152.
21. Iyer PG, Brooks HL Jr, Flynn HW Jr. Long-Term Favorable Visual Outcomes in Patients with Large Submacular Hemorrhage. Clin Ophthalmol. 2021; 15: 1189-92. http://doi.org/10.2147/OPTH.S300662.
22. Kumar A, Sahu A, Kaushik J et al. Unilateral submacular hemorrhage: Novel presentation of COVID-19 infection. J Med Virol. 2021; 93(7): 4122-3. http://doi.org/10.1002/jmv.26991.
23. Abdul-Salim I, Embong Z, Khairy-Shamel ST et al. Intravitreal ranibizumab in treating extensive traumatic submacular hemorrhage. Clin Ophthalmol. 2013; 7: 703-6. http://doi.org/10.2147/OPTH.S42208.
24. Imazeki M, Noma H, Yasuda K et al. Anti-VEGF Therapy Reduces Inflammation in Diabetic Macular Edema. Ophthalmic Res. 2021; 64(1): 43-9. http://doi.org/10.1159/000508953.
25. Quiroz-Mendoza JL, Valera-Cornejo DA, García-Roa M et al. Different approaches in the management of macular hemorrhage: Case reports and a literature review. Medwave. 2020; 20(2): e7831. http://doi.org/10.5867/medwave.2020.02.7831.
26. Jeong S, Park DG, Sagong M. Management of a Submacular Hemorrhage Secondary to Age-Related Macular Degeneration: A Comparison of Three Treatment Modalities. J Clin Med. 2020; 9(10): 3088. http://doi.org/10.3390/jcm9103088.
27. Grohmann C, Dimopoulos S, Bartz-Schmidt KU et al. Surgical management of submacular hemorrhage due to n-AMD: a comparison of three surgical methods. Int J Retina Vitreous. 2020; 6: 27. http://doi.org/10.1186/s40942-020-00228-x.
28. Mun Y, Park KH, Park SJ et al. Comparison of treatment methods for submacular hemorrhage in neovascular age-related macular degeneration: conservative versus active surgical strategy. Sci Rep. 2022; 12(1): 14875. http://doi.org/10.1038/s41598-022-18619-5.
29. Ali Said Y, Dewilde E, Stalmans P. Visual Outcome after Vitrectomy with Subretinal tPA Injection to Treat Submacular Hemorrhage Secondary to Age-Related Macular Degeneration or Macroaneurysm. J Ophthalmol. 2021; 2021: 3160963. http://doi.org/10.1155/2021/3160963.
30. Iannetta D, De Maria M, Bolletta E et al. Subretinal Injection of Recombinant Tissue Plasminogen Activator and Gas Tamponade to Displace Acute Submacular Haemorrhages Secondary to Age-Related Macular Degeneration. Clin Ophthalmol. 2021; 15: 3649-59. http://doi.org/10.2147/OPTH.S324091.
31. Yokoyama S, Kaga T, Kojima T et al. Treatment of old submacular hemorrhage by subretinal endoscopic surgery and intraoperative subretinal endoscopic findings. Am J Ophthalmol Case Rep. 2022; 25: 101393. http://doi.org/10.1016/j.ajoc.2022.101393.
32. Kaga T, Kojima T, Yokoyama S et al. Subretinal endoscopic surgery to treat large subretinal hemorrhages secondary to age-related macular degeneration. Retina. 2019; 39(5): 896-905. http://doi.org/10.1097/IAE.0000000000002031.
33. Tranos P, Tsiropoulos GN, Koronis S et al. Comparison of subretinal versus intravitreal injection of recombinant tissue plasminogen activator with gas for submacular hemorrhage secondary to wet age-related macular degeneration: treatment outcomes and brief literature review. Int Ophthalmol. 2021; 41(12): 4037-46. http://doi.org/10.1007/s10792-021-01976-x.
34. Pappas G, Vidakis N, Petousis M et al. An Innovatory Surgical Technique for Submacular Hemorrhage Displacement by Means of a Bioengineering Perspective. Vision (Basel). 2021; 5(2): 23. http://doi.org/10.3390/vision5020023.