Retina (Philadelphia, Pa.) · 2026
VITRECTOMY WITH SUBRETINAL TENECTEPLASE AND INTRAVITREAL CONBERCEPT FOR SUBMACULAR HEMORRHAGE: A Prospective Interventional Study.
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Cui Mingwei, Zhen Xiaomei, Si Shancheng
Аннотация
PURPOSE: To introduce a vitrectomy technique for the submacular hemorrhage (SMH) combined with subretinal tenecteplase injection, intravitreal conbercept administration, perfluoropropane gas tamponade, and to evaluate its efficacy and safety.
METHODS: In this single-center, prospective, interventional study, patients underwent 25-gauge vitrectomy with subretinal tenecteplase and intravitreal conbercept injection, followed by 0.5 to 1.0 mL of pure perfluoropropane gas tamponade. The best-corrected visual acuity and central retinal thickness were assessed at baseline, and 1 month, 3 months, and 6 months postoperatively. Favorable outcome was defined as a best-corrected visual acuity ≤0.5 logarithm of the minimum angle of resolution at 6 months.
RESULTS: Twenty eyes of 20 patients with treatment-naïve spontaneous SMH (≤30 days) secondary to polypoidal choroidal vasculopathy (70%) or retinal arterial macroaneurysms (30%) were included. Mean central retinal thickness significantly decreased from 887.1 ± 52.2 µ m to 276.7 ± 83.8 µ m ( P < 0.001) at 6 months. Notably, 75% of the treated eyes (13 out of 20) achieved a favorable outcome (best-corrected visual acuity ≤0.5 logarithm of the minimum angle of resolution; Snellen equivalent ≈ 20/63). Pearson correlation analysis revealed that the SMH onset-vitrectomy interval was significantly negatively correlated with a favorable outcome (r = -0.452, P = 0.045). After adjusting for potential interaction effect, the SMH onset-vitrectomy interval remained a statistically significant predictor of worse logarithm of the minimum angle of resolution best-corrected visual acuity (odds ratio = 1.023, 95% confidence interval, 1.013-1.034, P < 0.001).
CONCLUSION: The present technique for treatment-naïve spontaneous SMH, in combination with subretinal tenecteplase injection, intravitreal conbercept administration, and perfluoropropane gas tamponade, demonstrated potential for visual improvement in eyes treated within 30 days of SMH onset.
METHODS: In this single-center, prospective, interventional study, patients underwent 25-gauge vitrectomy with subretinal tenecteplase and intravitreal conbercept injection, followed by 0.5 to 1.0 mL of pure perfluoropropane gas tamponade. The best-corrected visual acuity and central retinal thickness were assessed at baseline, and 1 month, 3 months, and 6 months postoperatively. Favorable outcome was defined as a best-corrected visual acuity ≤0.5 logarithm of the minimum angle of resolution at 6 months.
RESULTS: Twenty eyes of 20 patients with treatment-naïve spontaneous SMH (≤30 days) secondary to polypoidal choroidal vasculopathy (70%) or retinal arterial macroaneurysms (30%) were included. Mean central retinal thickness significantly decreased from 887.1 ± 52.2 µ m to 276.7 ± 83.8 µ m ( P < 0.001) at 6 months. Notably, 75% of the treated eyes (13 out of 20) achieved a favorable outcome (best-corrected visual acuity ≤0.5 logarithm of the minimum angle of resolution; Snellen equivalent ≈ 20/63). Pearson correlation analysis revealed that the SMH onset-vitrectomy interval was significantly negatively correlated with a favorable outcome (r = -0.452, P = 0.045). After adjusting for potential interaction effect, the SMH onset-vitrectomy interval remained a statistically significant predictor of worse logarithm of the minimum angle of resolution best-corrected visual acuity (odds ratio = 1.023, 95% confidence interval, 1.013-1.034, P < 0.001).
CONCLUSION: The present technique for treatment-naïve spontaneous SMH, in combination with subretinal tenecteplase injection, intravitreal conbercept administration, and perfluoropropane gas tamponade, demonstrated potential for visual improvement in eyes treated within 30 days of SMH onset.