Current management of subretinal hemorrhage in neovascular age-related macular degeneration

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dc.contributor.authorOncel, Damla
dc.contributor.authorOncel, Deniz
dc.contributor.authorMishra, Kapil
dc.contributor.authorOncel, Murat
dc.contributor.authorArevalo, J. Fernando
dc.date.accessioned2024-05-19T14:46:50Z
dc.date.available2024-05-19T14:46:50Z
dc.date.issued2023
dc.departmentİstinye Üniversitesien_US
dc.description.abstractAge-related macular degeneration (AMD) is the leading cause of irreversible vision loss among individuals aged 65 years and older in the United States. For individuals diagnosed with age-related macular degeneration (AMD), approximately 12% experience varying levels of subretinal hemorrhage (SRH), which can be further classified by size into small, medium, and massive measured in disc diameters. SRH are an acute and rare sight-threatening complication characterized by an accumulation of blood under the retina arising from the choroidal or retinal circulation. Released iron toxins, reduced nutrient supply, fibrin meshwork contraction, and outer retinal shear forces created by SRH contribute to visual loss, macular scarring, and photoreceptor damage. SRH treatment strategies aim to displace hemorrhage from the foveal region and prevent further bleeding. Although there are no standardized treatment protocols for SRH, several surgical and non-surgical therapeutical approaches may be employed. The most common surgical approaches that have been utilized are pars plana vitrectomy (PPV) combined with multiple maneuvers such as the removal of choroidal neovascularization (CNV) lesions, macular translocation, retinal pigment epithelium (RPE) patch repair, SRH drainage, intravitreal injection of recombinant-tissue plasminogen activator (tPA), expansile gas and air displacement, and anti-vascular endothelial growth factor (anti-VEGF) injections. Non-surgical therapeutical approaches include intravitreal anti-VEGF monotherapy, intravitreal t-PA administration without PPV, and photodynamic therapy (PDT). This review article aims to explore the current treatment strategies and supporting literature regarding both surgical and non-surgical, of SRH in patients with AMD. Moreover, this article also aims to highlight the distinct treatment modalities corresponding to different sizes of SRH.en_US
dc.identifier.doi10.1159/000534440
dc.identifier.endpage305en_US
dc.identifier.issn0030-3755
dc.identifier.issn1423-0267
dc.identifier.issue5-6en_US
dc.identifier.pmid37806303en_US
dc.identifier.scopus2-s2.0-85178577003en_US
dc.identifier.scopusqualityQ1en_US
dc.identifier.startpage295en_US
dc.identifier.urihttps://doi.org10.1159/000534440
dc.identifier.urihttps://hdl.handle.net/20.500.12713/5602
dc.identifier.volume246en_US
dc.identifier.wosWOS:001085998600001en_US
dc.identifier.wosqualityN/Aen_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakScopusen_US
dc.language.isoenen_US
dc.publisherKargeren_US
dc.relation.ispartofOphthalmologicaen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/closedAccessen_US
dc.snmz20240519_kaen_US
dc.subjectSubretinal Hemorrhageen_US
dc.subjectChoroidal Neovascularizationen_US
dc.subjectAge-Related Macular Degenerationen_US
dc.subjectPars Plana Vitrectomyen_US
dc.subjectAnti-Vegfen_US
dc.subjectPneumatic Displacementen_US
dc.subjectTissue Plasminogen Activatoren_US
dc.titleCurrent management of subretinal hemorrhage in neovascular age-related macular degenerationen_US
dc.typeArticleen_US

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