ArticleGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie2026
Comparison of current treatment strategies for AMD-related submacular haemorrhage: Real-world outcomes.
Article in Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2026. 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
purposeComparison of available treatment modalities for neovascular AMD-related submacular haemorrhage including robot-assisted subretinal drug delivery.
methodsSingle centre, long-term, retrospective analysis of patients treated for nAMD-related submacular haemorrhage. For each treatment group, outcomes assessed included haemorrhage resolution and best corrected visual acuity (BCVA) change with sub-analyses by haemorrhage size.
resultsWe identified 55 patients with classic nAMD-related submacular haemorrhage. We observed a preference for the surgical approach injecting subretinal TPA (manual or robotic) with intravitreal anti-VEGF and pneumatic displacement (30 cases: 8:10:12 ratio of small:medium:large haemorrhage), over intravitreal TPA/anti-VEGF/pneumatic displacement (13 cases: 4:5:4) or intravitreal anti-VEGF alone (12 cases 8:4:0). Subretinal TPA led to significant decrease in haemorrhage size by month 1 compared to intravitreal TPA or anti-VEGF monotherapy (p < 0.0001, Tukey test) with most cases resolving by 12 months irrespective of the treatment group. Mean BCVA change over 12 months was not significantly different between treatment groups, although by 12 months + 15 letter gain was observed post subretinal TPA, + 11 after intravitreal TPA and -7 letters loss after anti-VEGF monotherapy. A higher proportion of patients in the surgical group (53% subretinal and 69% intravitreal TPA) were associated with BCVA improvement, or stabilisation (33% and 15% respectively), while anti-VEGF alone led to more frequent BCVA deteriorations (50% of cases). Robot-assisted TPA injection showed comparable result to the manual technique.
conclusionsSubretinal TPA approach, manual and robotic, resulted most effective clearance of submacular haemorrhage in the early post-operative phase, with some potential clinical benefit for longer term visual function.
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