ArticleGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie2025
Poor long-term fellow-eye outcomes after vitrectomy with subretinal tissue plasminogen activator for AMD-related submacular hemorrhage.
Article in Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo evaluate the long-term prognosis of the fellow-eye in patients with age-related macular degeneration (AMD) who underwent pars plana vitrectomy (PPV) with submacular tissue plasminogen activator injection (SM-tPA) for significant submacular hemorrhage.
methodsRetrospective single-center cohort study including all consecutive patients who underwent PPV with SM-tPA for AMD-related submacular hemorrhage (SMH) between 2010 and 2022, with a minimum follow-up of 2 years. Data was collected from electronic medical records and included demographic characteristics, visual acuity, optical coherence tomography findings, adverse events, further ocular diagnoses in the fellow-eye.
resultsForty-seven patients (57% male; mean age 80 years) were included, with a mean follow-up of 82 months. At baseline, most patients had AMD in the fellow-eye (62% dry-AMD; 30% wet-AMD). During follow-up, AMD progressed in 64% of the patients who did not have wet-AMD in their fellow eye at the time of presentation. Seven patients (15%) experienced SMH in the fellow-eye within 1 month to 5 years after initial surgery. The mean VA of the fellow-eye at presentation was 0.64 LogMAR, with a nonsignificant improvement in the first two years. Subsequently, a statistically significant VA deterioration was observed (final mean VA 0.8 LogMAR, p=0.009). By the final follow-up, 30% of patients had better VA in the operated eye, and 26% were legally blind in the fellow-eye.
conclusionPatients treated with SM-tPA are at high risk for AMD progression and vision loss in the fellow-eye. Close monitoring of the fellow eye is warranted, and treatment decisions for the involved eye should not be based solely on good fellow-eye vision, given the long-term risk of deterioration.
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