Retinal sensitivity after displacement of submacular hemorrhage due to polypoidal choroidal vasculopathy: effectiveness and safety of subretinal tissue plasminogen activator

To investigate the effectiveness of displacement of submacular hemorrhage (SMH) caused by polypoidal choroidal vasculopathy (PCV) by assessing retinal sensitivity using microperimetry. We retrospectively reviewed the medical records of 11 consecutive PCV patients with SMH. All patients underwent vitrectomy, subretinal injection of tissue plasminogen activator, and fluid-air exchange, followed by antivascular endothelial growth factor therapy using a pro re nata regimen. The retinal sensitivity was measured by use of microperimetry before and after surgery. The mean (SD) age of the patients was 74.1 +/- 9.4 years. The mean SMH diameter was 6.8 +/- 5.2 disc diameters. The best-corrected visual acuity (BCVA), mean retinal sensitivity, and mean number of measure points with a sensitivity >= 10 dB before the surgery were 0.94 +/- 0.49, 4.2 +/- 4.5 dB, and 15.6 +/- 15.1 points, respectively. These had significantly improved 6 months after surgery (0.39 +/- 0.37, 15.6 +/- 7.3 dB, and 50.9 +/- 22.2 points, respectively; P < 0.05 for all outcome measures). The mean number of measure points with an absolute scotoma before surgery had decreased significantly 6 months after surgery (from 40.5 +/- 15.0 to 9.4 +/- 16.0 points; P < 0.001). Displacement of SMH effectively improves retinal sensitivity as well as BCVA.