Introduction:

The combined use of bevacizumab and intraretinal alteplase is an alternative treatment for macular hemorrhage that is becoming more and more relevant. In addition, its use in a single syringe prevents an intraretinal injection reducing the possible risks involved.

Objective:

To confirm the effectiveness and safety of the combination of bevacizumab and alteplase in vivo for submacular hemorrhage in patients with macular degeneration associated with age and to determine whether it is a valid treatment alternative.

Material and methods:

Observational retrospective study of patients treated with bevacizumab and alteplase for submacular hemorrhages from February 2017 to February 2018. The clinical situation was reviewed pre-intervention and at 3 months later. The variables reviewed to determine the effectiveness of the treatment were the size of the hemorrhage surface, the retinal thickness and the visual acuity. Safety was determined with the appearance of adverse reactions.

Results:

Six eyes of five patients were included, 60% men, with a median age of 78 years (68-89). Objectively the percentage of occupation of the hemorrhage was reduced from an average of 70% to 6% after the intervention. The retinal thickness decreased from 1,531 microns (1,891-1,195) to 516.8 microns (324-667). Visual acuity improved in two patients and remained in the rest. All patients reported subjectively improvement after the intervention. The treatment was safe due to the absence of adverse reactions.

Conclusions:

The reviewed treatment has shown to be clinically effective and safe.

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