Evaluation of the long-term outcomes of surgery of submacular hemorrhage in patients with exudative age-related macular degeneration

Purpose. To evaluate the long-term outcomes of surgery of submacular hemorrhage (SMH) in patients with exudative age-related macular degeneration. Material and methods. A dynamic follow-up of 32 patients with SMH (32 eyes) was carried out, who underwent 25G endovitreal intervention with subretinal injection of 1000 to 3000 IU of the Gemaza drug. The area of the SMH in all cases was extensive with the capture of the fovea. The follow-up period ranged from 24 to 30 months. Results. There was displacement of almost the entire volume of SMH from the macular area to the low periphery in all operated eyes by the next day after the operation. There were complete elimination of SMH and the formation of a normal configuration of the macular profile in 7 days after surgery in all eyes. All patients were satisfied with the results of the surgery according to significant increase of visual acuity and disappearance of a spot in the central visual field. Postoperative complications appeared in four eyes at different times of follow up period, but they were eliminated after reoperation. Conclusion. Subretinal administration of the drug Gemaza and pneumodislocation of the blood clot is an effective method for the treatment of SMH with a limitation period of up to 2 weeks. In the vast majority of cases (88%), it was possible to achieve complete elimination of the SMH and a significant improvement in central vision. Key words: submacular hemorrhage, Gemaza, recombinant prourokinase, age-related macular degeneration, subretinal neovascular membrane