黄斑变性
医学
视力
眼科
血管抑制剂
阿柏西普
荟萃分析
脉络膜新生血管
贝伐单抗
内科学
化疗
作者
Daniele Veritti,Valentina Sarao,Deborah Martinuzzi,Sara Menzio,Paolo Lanzetta
出处
期刊:Ophthalmologica
[S. Karger AG]
日期:2024-03-29
卷期号:: 1-11
摘要
<b><i>Background:</i></b> Submacular hemorrhage (SMH) associated with neovascular age-related macular degeneration (nAMD) precipitates rapid visual decline and impacts quality of life. Treatments vary, but combined recombinant tissue plasminogen activator (tPA) and anti-vascular endothelial growth factor (anti-VEGF) therapy has gained prominence as a viable treatment option. <b><i>Objectives:</i></b> This study aimed to evaluate the efficacy of the combination of tPA and anti-VEGF. <b><i>Methods:</i></b> We conducted a systematic review meta-analysis following PRISMA guidelines, focusing on studies examining tPA and anti-VEGF therapy in SMH secondary to nAMD. Outcomes measured were change in best-corrected visual acuity (BCVA) and success rate of SMH displacement. Meta-regression assessed the relative efficacy of intravitreal and subretinal delivery. <b><i>Results:</i></b> Out of 257 initial reports, 22 studies involving 29 patient populations met inclusion criteria. Our analysis showed significant improvement in BCVA and a high rate of successful SMH displacement with combined tPA and anti-VEGF therapy. No significant differences were found between subretinal and intravitreal tPA administration. Furthermore, when evaluating the effects of subretinal versus intravitreal anti-VEGF administration in patients treated with subretinal tPA, the results indicated similar efficacy. <b><i>Conclusions:</i></b> Combined tPA and anti-VEGF therapy is effective in managing SMH in nAMD patients, significantly improving visual acuity and SMH displacement. The location of tPA and anti-VEGF delivery did not significantly impact outcomes.
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