2010-22: Intravitreal versus submacular injection of rtPA for acute submacular haemorrhages.
Submacular haemorrhage (SMH) is a severe complication of age-related macular degeneration (AMD). Anti-VEGF injections, the current standard treatment for exudative AMD, appear to be ineffective when a (large) SMH is present. If untreated, the SMH itself will cause irreversible damage to the retina and retinal pigment epithelium (RPE). In this prospective, randomized, explorative intervention study the investigators examine which administration route of recombinant tissue plasminogen activator (rtPA) is safe and effective. Consecutive patients with SMH existing ≤ 14 days at time of surgery will be asked to participate in this study. The study arms are 1: submacular rtPA with pars plana vitrectomy (ppV), intravitreal C3F8/air mixture and bevacizumab, and 2: intravitreal rtPA, C3F8 gas and bevacizumab. The study endpoints are safety and the location and size of haemorrhage at six weeks.