Objectives To investigate the efficacy of gravitational displacement following vitrectomy for the patients with submacular haemorrhage (SMH) secondary to age-related macular degeneration (AMD). Methods Retrospective, interventional series of nine consecutive AMD patients with SMH. All patients underwent pars plana vitrectomy (PPV) combined with subretinal tissue plasminogen activator (t-PA) and intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection without any tamponade. The patients were positioned according to the location and distribution of SMH postoperatively in order to provide the maximum gravitational force effect to displace. Outcome measures were the change in visual acuity, the displacement in SMH, and the occurrence of per- and postoperative complications. Results Complete displacement of haemorrhage occurred in all patients postoperatively. The mean preoperative and postoperative best-corrected visual acuity (BCVA) at the last visit were 2.46 and 1.7 logMAR, respectively, after a mean follow-up of 10.4 months (Range: 3–18 months) ( p = 0.045). The mean duration of haemorrhage was 15.3 days (range: 3–40 days). The recurrence of SMH was observed in two (22%) patients and there were no other postoperative complications. Conclusion Gravitational displacement following PPV combined with subretinal t-PA and intravitreal anti-VEGF injection can be considered as an effective surgical intervention in selected AMD patients with SMH.

中文翻译：

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年龄相关性黄斑部疾病患者黄斑下出血的重力位移

目的 探讨玻璃体切割术后重力移位治疗继发于年龄相关性黄斑变性 (AMD) 的黄斑下出血 (SMH) 患者的疗效。方法 回顾性、介入性系列 9 名连续 AMD 患者的 SMH。所有患者均接受了平部玻璃体切除术（PPV）联合视网膜下组织纤溶酶原激活剂（t-PA）和玻璃体内抗血管内皮生长因子（anti-VEGF）注射，无任何填塞。术后根据SMH的位置和分布对患者进行定位，以提供最大的重力效应进行移位。结果指标是视力的变化、SMH 的位移以及术前和术后并发症的发生率。结果术后所有患者均出现完全移位的出血。在平均随访 10.4 个月（范围：3-18 个月）后，最后一次访视时的平均术前和术后最佳矫正视力 (BCVA) 分别为 2.46 和 1.7 logMAR (p = 0.045)。出血的平均持续时间为 15.3 天（范围：3-40 天）。在两名（22%）患者中观察到 SMH 复发，并且没有其他术后并发症。结论 PPV 后重力置换联合视网膜下 t-PA 和玻璃体内注射抗 VEGF 可作为对选定的 AMD 合并 SMH 患者的有效手术干预。经过平均 10.4 个月的随访（范围：3-18 个月）（p = 0.045）。出血的平均持续时间为 15.3 天（范围：3-40 天）。在两名（22%）患者中观察到 SMH 复发，并且没有其他术后并发症。结论 PPV 后重力置换联合视网膜下 t-PA 和玻璃体内注射抗 VEGF 可作为选定的 AMD 合并 SMH 患者的有效手术干预。经过平均 10.4 个月的随访（范围：3-18 个月）（p = 0.045）。出血的平均持续时间为 15.3 天（范围：3-40 天）。在两名（22%）患者中观察到 SMH 复发，并且没有其他术后并发症。结论 PPV 后重力置换联合视网膜下 t-PA 和玻璃体内注射抗 VEGF 可作为对选定的 AMD 合并 SMH 患者的有效手术干预。