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How to choose the appropriate treatment plan for subretinal hemorrhage?

Posting time:2022-12-03 08:59:22

How to choose the appropriate treatment plan for subretinal hemorrhage?

Editor's note: Subretinal hemorrhage is a common clinical fundus disease, often located in the macula, and may be accompanied by preretinal hemorrhage or subpigmentary hemorrhage, resulting in a sharp decrease in central vision. At present, the treatment of subretinal hemorrhage has always been a hot and difficult topic of everyone's attention. At the Euretina 2022 conference, international fundus experts brought new insights and research on the treatment of subretinal hemorrhage. Come and listen to the front-line information of "International Ophthalmology News". Treatment options for subretinal hemorrhage Massive submacular hemorrhage is a serious complication of age-related macular degeneration with a often poor prognosis and lack of appropriate clinical guidelines for treatment. Previous treatment regimens included anti-VEGF injection, surgical resection ± intravitreal or subretinal tPA followed by anti-VEGF injection. Sarah Touhami's team from France shared their latest research in this field. Anti-VEGF injection is mainly suitable for patients with hemorrhage under RPE and a small amount of subretinal hemorrhage, and the fundus structure can basically return to normal after treatment. Vitrectomy + tPA + gas-liquid exchange is suitable for patients with more bleeding and bleeding on RPE. Early surgical treatment can help patients obtain better therapeutic effects. Summary: Subretinal hemorrhage needs to be treated as soon as possible. In order to reduce the recurrence rate of the disease, anti-VEGF injection can be performed once a month. The surgical effect is more obvious but the risk of complications is higher. Larger studies are needed in the future to clarify treatment guidelines for different subretinal hemorrhage types. Study of the effectiveness of subretinal hemorrhage treatment regimens Subretinal hemorrhage disrupts the diffusion barrier of nutrients and oxygen, causes contraction of the fibrin network, produces ferrous iron and hemosiderin with retinal neurotoxicity, and bleeds larger than one optic disc diameter or Visual acuity less than 0.1 requires immediate treatment. The choice of treatment plan for subretinal hemorrhage is particularly important. Although surgical treatment is effective, the changes in hemodynamics and air pressure caused by it may also cause a variety of complications. In clinical work, the appropriate treatment plan is generally selected according to the duration of symptoms, changes in vision, the patient's treatment expectations, and whether there is vitreous hemorrhage. Without treatment, most patients do not recover on their own and have a poor visual prognosis. Previous studies have shown that patient prognosis is related to treatment options, and that patients who undergo vitrectomy have poorer visual outcomes than those who do not. Summary: With the progress of treatment methods, the research on the effectiveness of different surgical combination treatment plans has gradually been carried out. Different types of patients are suitable for different treatment plans, and it is necessary to fully consider the symptoms and prognostic needs of patients to select the most suitable surgical plan. The improvement of disease classification and the exploration of innovative treatment methods will help to improve the treatment efficiency of clinical programs, improve the quality of medical services and the prognosis of patients. Looking forward to the advent of newer and more effective treatment methods in the future to better protect the light.

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