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This abstract is assigned to session FAB: Fluorescein Angiography Club Belgium

Title

Subretinal tissue plasminogen activator injection to treat submacular hemorrhages in age related macula degeneration.

Purpose	To evaluate the efficacy and safety of transconjunctival sutureless vitrectomy subretinal tissue plasminogen activator injection and pneumatic displacement of the hemorrhage with air as a treatment for submacular hemorrhages secondary to neovascular age-related macular degeneration.
Methods	We retrospectively evaluated the records of 58 patients with submacular hemorrhage caused by neovascular age-related macular degeneration, that underwent 23 Gauche transconjunctival sutureless vitrectomy with subretinal tissue plasminogen activator and air tamponade between November 2008 and July 2011. Intravitreal anti-VEGF was administered to the patients postoperatively when indicated
Results	The submacular hemorrhage was successfully displaced in most of the cases. The visual acuity improved significantly in 39 patients (67 %), stabilized in 12 patients (21 %) and decreased in 7 patients (12 %). Complications consisted of 5 cases of retinal detachment, 3 vitreous hemorrhages and 2 subchoroidal hemorrhages during the follow-up period. Most of the cases needed further treatment with anti-VEGF after surgery as the choroidal neovascular membrane was still active.
Conclusion	Subretinal injection of tissue plasminogen activator seems to be an effective treatment in patients with submacular hemorrhage. Moreover, the surgical morbidity of this technique is minimal because the surgery is performed using the 23G sutureless technique, it can be performed under local anesthesia and prolonged postoperative positioning is not necessary. Nevertheless, the underlying disease stays the most important prognostic factor for visual outcome.

Author 1

Last name	DELAERE
Initials	L
Department	Oogheelkunde UZLeuven
City	LEUVEN

Author 2

Last name	Vaninbroukx
Initials	I
Department	Oogheelkunde UZLeuven
City	LEUVEN

Author 3

Last name	Van Calster
Initials	J
Department	Oogheelkunde UZLeuven
City	LEUVEN

Author 4

Last name	Stalmans
Initials	P
Department	Oogheelkunde UZLeuven
City	LEUVEN