Wet AMD is one of the most frequent ophthalmic disorders. Thanks to anti-VEGF medications, which have been successfully used in this condition since 2006, there is a good chance of maintaining useful visual acuity in majority of patient with CNV. Efficacy of anti-VEGF drugs reduced the frequency of surgical methods used to treat wet AMD. There are however cases which, if not treated in more aggressive way, would not have chances for maintaining good vision. One of the example is subretinal hemorrhage in macular area due to active CNV. The aim of this presentation is to show the cases of submacular hemorrhages in wet AMD which were successfully treated with sub retinal t-pa , intravitreal AVASTIN and SF 6 tamponade. There are publications demonstrating intravitreal use of t-pa together with gas tamponade. In this setting t-pa must cross the retinal barrier and gas tamponade together with positioning is believed to display the hemorrhage. Some authors believe that only displacement of hemorrhage is not successful or the hemorrhage is greater than 3 disc diameter one should consider sub retinal t-pa. During the presentation I will show cases of sub retinal use of t-pa in moderate and severe cases. I will also show the case of successful sub retinal t-pa even 6 weeks after the hemorrhage onset. In my opinion using sub retinal t-pa is more precise and give a chance of directing the treatment exactly where it is needed. We also need to remember that some of these patients have the other eye lost to AMD.



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