Intravitreal aflibercept, gas injections effective for submacular hemorrhage

The use of intravitreal aflibercept followed by gas injections was found to be relatively safe and effective for submacular hemorrhage (SMH) associated with polypoidal choroidal vasculopathy (PCV), according to a study.

In this retrospective study, the medical records of 22 eyes with SMH secondary to PCV that received intravitreal aflibercept and 100% perfluoropropane (0.3-0.5 mL) followed by 3-day prone positioning were analyzed. Best-corrected visual acuity (BCVA) at 12 months was the primary outcome.

The average SMH size was 13.0 ± 9.7 (range, 2.0-37.8) disc diameter. Complete displacement of the SMH was observed in 8 (36%) eyes, partial displacement in 9 (41%) eyes, and no displacement in 5 (23%) eyes.

At baseline, BCVA was .81 ± 0.41 (Snellen equivalent, 20/125), which significantly improved to 0.48 ± 0.44 (20/60) at 3 months, 0.33 ± 0.39 (20/43) at 6 months, and 0.28 ± 0.45 (20/38) at 12 months.

Overall, the BCVA in 64% of eyes improved by ≥3 lines. Visually significant vitreous hemorrhage occurred in 9% of eyes and rhegmatogenous retinal detachment in 5% of eyes.

Baseline lower height of the SMH and greater displacement of SMH were associated with better BCVA at 12 months; anticoagulant medication was associated with worse BCVA.

Reference
Wakabayashi T, Hara C, Shiraki A, et al. Simultaneous intravitreal aflibercept and gas injections for submacular hemorrhage secondary to polypoidal choroidal vasculopathy. Graefes Arch Clin Exp Ophthalmol. 2022;doi: 10.1007/s00417-022-05922-0. Epub ahead of print. PMID: 36473986.