Visual acuity outcomes similar for anti-VEGF and surgery in submacular hemorrhage

Both anti-VEGF injections and surgical interventions are effective for treating submacular hemorrhage caused by neovascular age-related macular degeneration, achieving similar visual acuity outcomes, according to a study. However, anti-VEGF injections generally have a better safety profile, with lower rates of complications such as cataracts, proliferative vitreoretinopathy, and retinal detachment.

Researchers reviewed 43 observational studies, including 21 on anti-VEGF injections (960 eyes) and 22 on surgical interventions (455 eyes). They found no significant difference in mean visual acuity outcomes between anti-VEGF and surgery, with mean differences of -0.16 (95% CI: -0.26, -0.07) and -0.36 (95% CI: -0.68, -0.04), respectively. However, heterogeneity was high in surgical studies, while anti-VEGF studies showed minimal variability.

Anti-VEGF injections were associated with fewer complications compared to surgery, including lower rates of cataract (0% vs 4.6%), proliferative vitreoretinopathy (0.1% vs 2.0%), and retinal detachment (0.1% vs 10.6%). Recurrent hemorrhage rates were similar between the treatments (5.4% for anti-VEGF vs 5.3% for surgery).

Reference
Shaheen A, Mehra D, Ghalibafan S, et al. Efficacy and Safety of Anti-VEGF Injections and Surgery for AMD-Related Submacular Hemorrhage: A Systematic Review & Meta-Analysis. Ophthalmol Retina. 2024;S2468-6530(24)00359-2. doi: 10.1016/j.oret.2024.07.024. Epub ahead of print. PMID: 39098637.