Postoperative follow-up of submacular hemorrhage displacement treated with vitrectomy and subretinal injection of tissue plasminogen activator: ultrawide-field fundus autofluorescence imaging in gas-filled eyes

Jpn J Ophthalmol. 2022 May;66(3):264-270. doi: 10.1007/s10384-022-00910-7. Epub 2022 Mar 9.

Abstract

Purpose: To investigate the utility of Optos ultrawide-field fundus autofluorescence (UWF-FAF) imaging for postoperative follow-up of gas-filled eyes after vitrectomy with subretinal tissue-plasminogen activator (t-PA) injection for subretinal hemorrhage (SRH) displacement.

Study design: Retrospective consecutive case series.

Methods: This study included 24 eyes with SRH. Vitrectomy with subretinal t-PA injection was performed, followed by postoperative prone positioning. FAF images acquired using Optos California were examined and the SRH occupancy in the macula was calculated. The main outcome measures were displacement rate and direction of SRH for 3 days postoperatively, and postoperative best-corrected visual acuity (BCVA).

Results: The postoperative BCVA ranged from improvement (23 eyes; 95.8%) to no change (one eye; 4.2%). Analysis was done using postoperative Optos FAF images for 20 eyes (83.3%). Postoperative SRH occupancy was significantly reduced, by 27.4%, compared with the preoperative occupancy (P = 0.03). A statistically significant reduction was found between the preoperative and postoperative day (POD)1 (P = 0.04), but not between POD1 and POD2 (P = 0.7), or between POD2 and POD3 (P = 1.0).

Conclusion: UWF-FAF imaging is useful for postoperative follow-up of gas-filled eyes after vitrectomy with subretinal t-PA injection for SRH displacement.

Keywords: Polypoidal choroidal vasculopathy; Prone position; Retinal arterial microaneurysm; Vitrectomy.

MeSH terms

  • Fibrinolytic Agents
  • Fluorescein Angiography
  • Follow-Up Studies
  • Humans
  • Optical Imaging
  • Retinal Hemorrhage / diagnosis
  • Retinal Hemorrhage / surgery
  • Retrospective Studies
  • Tissue Plasminogen Activator*
  • Treatment Outcome
  • Visual Acuity
  • Vitrectomy* / methods

Substances

  • Fibrinolytic Agents
  • Tissue Plasminogen Activator