眼科学报2025，Vol.40Issue(12)：993-1003,11.DOI:10.12419/25050201
新生血管性年龄相关性黄斑变性相关的黄斑下出血治疗方案的研究进展
Research advances in treatment strategies for subretinal hemorrhage complicated by neovascular age-related macular degeneration
摘要
Abstract
Submacular hemorrhage(SMH)is a severe complication of neovascular age-related macular degeneration(nAMD).If not promptly treated,it can lead to irreversible photoreceptor damage and vision loss.The severity of SMH is closely related to the volume,location,and duration of the bleeding.Extensive or prolonged submacular hemorrhage can significantly impair patients'visual function and quality of life.At present,the treatment strategies for SMH secondary to nAMD are primarily categorized into two major approaches:pars plana vitrectomy(PPV)combined with pharmacological therapy and non-surgical intravitreal injections.Surgical treatments that involve PPV along with subretinal injection of tissue plasminogen activator(tPA)can completely displace most SMH cases,leading to notable short-term improvements in vision.However,these procedures are associated with high recurrence rates,and most patients need long-term anti-vascular endothelial growth factor(anti-VEGF)maintenance therapy to keep neovascular activity under control.In contrast,intravitreal injection of tPA combined with expansile gas(SF6/C3F8)or anti-VEGF monotherapy offers a minimally invasive alternative,with the benefits of less trauma and faster recovery.Nonetheless,this approach has its limitations,particularly for extensive or long-standing hemorrhage,where its effectiveness may be less than ideal.When choosing a treatment strategies,multiple factors need to be taken into comprehensive consideration,such as the size,thickness,location,and duration of hemorrhage,as well as the patient's baseline visual acuity.Small SMH usually respond well to various treatment methods,while large SMH often require more aggressive surgical intervention.This systematic review conducts a thorough examination of treatment strategies,efficacy evaluations,and prognostic factors for SMH secondary to nAMD,Its aim is to offer references for clinical decision-making and help ophthalmologists devise optimal individualized treatment plans based on patient's specific conditions.关键词
新生血管性年龄相关性黄斑变性/黄斑下出血/玻璃体切割术/组织纤溶酶原激活剂/抗血管内皮生长因子/综述Key words
neovascular age-related macular degeneration/submacular hemorrhage/pars plana vitrectomy/tissue plasminogen activator/anti-vascular endothelial growth factor/review分类
医药卫生引用本文复制引用
黎明明,岑志敏,张皇,苏定旺..新生血管性年龄相关性黄斑变性相关的黄斑下出血治疗方案的研究进展[J].眼科学报,2025,40(12):993-1003,11.基金项目
广东省中山市科学技术局社会公益与基础研究项目资助(2023B3033).This work was supported by the Zhongshan Science and Technology Bureau Research Funding for the Social Welfare and Basic Research Project,China(2023B3033). （2023B3033）
