Comparative outcomes of pars plana vitrectomy with subretinal rt-PA injection in polypoidal choroidal vasculopathy: the role of simultaneous anti-VEGF treatment

PurposeThis study aimed to assess the efficacy of simultaneous intravitreal anti-vascular endothelial growth factor (VEGF) with pars plana vitrectomy (PPV), subretinal recombinant tissue plasminogen activator (rt-PA), and pneumatic tamponade in treating submacular hemorrhage (SMH) due to polypoidal...

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Main Authors: Lulu Chen, Chuting Wang, Wenfei Zhang, Lihui Meng, Lu Sun, Youxin Chen
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Medicine
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Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2025.1565507/full
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author Lulu Chen
Lulu Chen
Chuting Wang
Chuting Wang
Wenfei Zhang
Wenfei Zhang
Lihui Meng
Lihui Meng
Lu Sun
Lu Sun
Youxin Chen
Youxin Chen
author_facet Lulu Chen
Lulu Chen
Chuting Wang
Chuting Wang
Wenfei Zhang
Wenfei Zhang
Lihui Meng
Lihui Meng
Lu Sun
Lu Sun
Youxin Chen
Youxin Chen
author_sort Lulu Chen
collection DOAJ
description PurposeThis study aimed to assess the efficacy of simultaneous intravitreal anti-vascular endothelial growth factor (VEGF) with pars plana vitrectomy (PPV), subretinal recombinant tissue plasminogen activator (rt-PA), and pneumatic tamponade in treating submacular hemorrhage (SMH) due to polypoidal choroidal vasculopathy (PCV), compared to the procedure without anti-VEGF.MethodsWe retrospectively analyzed PCV patients with SMH who underwent the procedure at a tertiary hospital from 2021 to 2024. Outcomes comprised alterations in best-corrected visual acuity (BCVA), SMH absorption, and the administration of postoperative anti-VEGF injections.ResultsA total of 31 patients were included in the study. There was no significant difference in best-corrected visual acuity (BCVA) improvement or anti-VEGF usage between the anti-VEGF group and the control group. Both treatment strategies led to improved visual acuity. The mean number of anti-VEGF injections following surgery was 1.0 (8.0) in the anti-VEGF group and 1.0 (6.0) in the control group. Complications such as retinal detachment and recurrent vitreous hemorrhage occurred in both groups, with no significant difference between the groups.ConclusionSimultaneous intravitreal anti-VEGF did not outperform the procedure without it in terms of improved visual acuity or postoperative anti-VEGF usage. Further studies are needed to determine the best treatment approach for PCV patients with SMH.
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spelling doaj-art-09de3552cdf34637a4b9753354e839b32025-08-20T03:15:03ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-07-011210.3389/fmed.2025.15655071565507Comparative outcomes of pars plana vitrectomy with subretinal rt-PA injection in polypoidal choroidal vasculopathy: the role of simultaneous anti-VEGF treatmentLulu Chen0Lulu Chen1Chuting Wang2Chuting Wang3Wenfei Zhang4Wenfei Zhang5Lihui Meng6Lihui Meng7Lu Sun8Lu Sun9Youxin Chen10Youxin Chen11Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, ChinaKey Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing, ChinaDepartment of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, ChinaKey Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing, ChinaDepartment of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, ChinaKey Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing, ChinaDepartment of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, ChinaKey Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing, ChinaDepartment of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, ChinaKey Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing, ChinaDepartment of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, ChinaKey Laboratory of Ocular Fundus Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College Hospital, Beijing, ChinaPurposeThis study aimed to assess the efficacy of simultaneous intravitreal anti-vascular endothelial growth factor (VEGF) with pars plana vitrectomy (PPV), subretinal recombinant tissue plasminogen activator (rt-PA), and pneumatic tamponade in treating submacular hemorrhage (SMH) due to polypoidal choroidal vasculopathy (PCV), compared to the procedure without anti-VEGF.MethodsWe retrospectively analyzed PCV patients with SMH who underwent the procedure at a tertiary hospital from 2021 to 2024. Outcomes comprised alterations in best-corrected visual acuity (BCVA), SMH absorption, and the administration of postoperative anti-VEGF injections.ResultsA total of 31 patients were included in the study. There was no significant difference in best-corrected visual acuity (BCVA) improvement or anti-VEGF usage between the anti-VEGF group and the control group. Both treatment strategies led to improved visual acuity. The mean number of anti-VEGF injections following surgery was 1.0 (8.0) in the anti-VEGF group and 1.0 (6.0) in the control group. Complications such as retinal detachment and recurrent vitreous hemorrhage occurred in both groups, with no significant difference between the groups.ConclusionSimultaneous intravitreal anti-VEGF did not outperform the procedure without it in terms of improved visual acuity or postoperative anti-VEGF usage. Further studies are needed to determine the best treatment approach for PCV patients with SMH.https://www.frontiersin.org/articles/10.3389/fmed.2025.1565507/fullsubmacular hemorrhagepolypoidal choroidal vasculopathyrecombinant tissue plasminogen activatorsimultaneous anti-VEGFsurgical outcome
spellingShingle Lulu Chen
Lulu Chen
Chuting Wang
Chuting Wang
Wenfei Zhang
Wenfei Zhang
Lihui Meng
Lihui Meng
Lu Sun
Lu Sun
Youxin Chen
Youxin Chen
Comparative outcomes of pars plana vitrectomy with subretinal rt-PA injection in polypoidal choroidal vasculopathy: the role of simultaneous anti-VEGF treatment
Frontiers in Medicine
submacular hemorrhage
polypoidal choroidal vasculopathy
recombinant tissue plasminogen activator
simultaneous anti-VEGF
surgical outcome
title Comparative outcomes of pars plana vitrectomy with subretinal rt-PA injection in polypoidal choroidal vasculopathy: the role of simultaneous anti-VEGF treatment
title_full Comparative outcomes of pars plana vitrectomy with subretinal rt-PA injection in polypoidal choroidal vasculopathy: the role of simultaneous anti-VEGF treatment
title_fullStr Comparative outcomes of pars plana vitrectomy with subretinal rt-PA injection in polypoidal choroidal vasculopathy: the role of simultaneous anti-VEGF treatment
title_full_unstemmed Comparative outcomes of pars plana vitrectomy with subretinal rt-PA injection in polypoidal choroidal vasculopathy: the role of simultaneous anti-VEGF treatment
title_short Comparative outcomes of pars plana vitrectomy with subretinal rt-PA injection in polypoidal choroidal vasculopathy: the role of simultaneous anti-VEGF treatment
title_sort comparative outcomes of pars plana vitrectomy with subretinal rt pa injection in polypoidal choroidal vasculopathy the role of simultaneous anti vegf treatment
topic submacular hemorrhage
polypoidal choroidal vasculopathy
recombinant tissue plasminogen activator
simultaneous anti-VEGF
surgical outcome
url https://www.frontiersin.org/articles/10.3389/fmed.2025.1565507/full
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