Abstract
PURPOSE: This study aimed to assess the efficacy of simultaneous intravitreal anti-vascular endothelial growth factor (VEGF) with pars plana vitrectomy (PPV), subretinal recombinant tissue plasminogen activator (rt-PA), and pneumatic tamponade in treating submacular hemorrhage (SMH) due to polypoidal choroidal vasculopathy (PCV), compared to the procedure without anti-VEGF. METHODS: We retrospectively analyzed PCV patients with SMH who underwent the procedure at a tertiary hospital from 2021 to 2024. Outcomes comprised alterations in best-corrected visual acuity (BCVA), SMH absorption, and the administration of postoperative anti-VEGF injections. RESULTS: A total of 31 patients were included in the study. There was no significant difference in best-corrected visual acuity (BCVA) improvement or anti-VEGF usage between the anti-VEGF group and the control group. Both treatment strategies led to improved visual acuity. The mean number of anti-VEGF injections following surgery was 1.0 (8.0) in the anti-VEGF group and 1.0 (6.0) in the control group. Complications such as retinal detachment and recurrent vitreous hemorrhage occurred in both groups, with no significant difference between the groups. CONCLUSION: Simultaneous intravitreal anti-VEGF did not outperform the procedure without it in terms of improved visual acuity or postoperative anti-VEGF usage. Further studies are needed to determine the best treatment approach for PCV patients with SMH.