RT info:eu-repo/semantics/article
T1 Interventions for submacular haemorrhage: A systematic review and network meta‐analysis of controversies—On behalf of the Spanish Vitreo‐Retinal Society (SERV)
A1 Pastor Idoate, Salvador
A1 Redruello Guerrero, Pablo
A1 Juan Hernández, Laura de
A1 Benites Narcizo, Gregorio
A1 Rivera Izquierdo, Mario
A1 García Arumí, José
A1 Pastor Jimeno, José Carlos
K1 Degeneración macular relacionada con la edad
K1 Factor de crecimiento endotelial antivascular
K1 Vitrectomía pars plana
K1 Desplazamiento neumático
K1 Vasculopatía coroidea polipoide
K1 Hemorragia submacular
K1 Hemorragia subretiniana
K1 Activador tisular del plasminógeno
AB PurposeThis systematic review aims to evaluate and synthesize the existing literature on the interventions used for submacular haemorrhage (SMH), highlighting the controversies and differences in clinical practice.MethodA systematic review was conducted following the PRISMA guidelines. A comprehensive search was performed across multiple databases, including MEDLINE, EMBASE and Cochrane Library, to identify studies on SMH treatment. Inclusion criteria encompassed randomized controlled trials, cohort studies and case series that focused on different therapeutic interventions. Data on functional outcomes, efficacy and safety of the interventions were extracted and analysed.ResultsThe review included 150 studies, of which 38 were included in the network meta-analysis. The analysis of best corrected visual acuity (BCVA) Included 26 studies, 20 interventions and 2125 eyes. Heterogeneity was moderate (I2 = 28.9%). Non-vitrectomy therapies showed better BCVA outcomes and fewer complications (e.g. retinal detachment, vitreous haemorrhage), while vitrectomy-based treatments achieved better anatomical results. According to P-score ranking, “Observation” had the highest probability of being most effective for BCVA (P-score = 0.8051), followed by anti-VEGF monotherapy and non-vitrectomy combinations. However, this result should be interpreted cautiously, as the “Observation” group was based on only two studies (26 eyes) with clinical heterogeneity. No publication bias was detected (Egger's test p = 0.582).ConclusionsThere is no consensus on a standard evidence-based treatment for SMH. Minimally invasive strategies are promising, but factors such as timing, lesion size and anti-VEGF use remain critical. Further large-scale randomised trials are needed to define optimal management.
PB Wiley
SN 1755-375X
YR 2025
FD 2025
LK https://uvadoc.uva.es/handle/10324/78399
UL https://uvadoc.uva.es/handle/10324/78399
LA eng
NO Acta Ophthalmologica, 2025, p. 1-25
NO Producción Científica
DS UVaDOC
RD 09-oct-2025