{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,15]],"date-time":"2026-02-15T15:10:42Z","timestamp":1771168242497,"version":"3.50.1"},"reference-count":165,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T00:00:00Z","timestamp":1754524800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T00:00:00Z","timestamp":1754524800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Ophthalmologica"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>\n                      This systematic review aims to evaluate and synthesize the existing literature on the interventions used for submacular haemorrhage (\n                      <jats:styled-content style=\"fixed-case\">SMH<\/jats:styled-content>\n                      ), highlighting the controversies and differences in clinical practice.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>\n                      A systematic review was conducted following the\n                      <jats:styled-content style=\"fixed-case\">PRISMA<\/jats:styled-content>\n                      guidelines. A comprehensive search was performed across multiple databases, including\n                      <jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content>\n                      ,\n                      <jats:styled-content style=\"fixed-case\">EMBASE<\/jats:styled-content>\n                      and Cochrane Library, to identify studies on\n                      <jats:styled-content style=\"fixed-case\">SMH<\/jats:styled-content>\n                      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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The review included 150 studies, of which 38 were included in the network meta\u2010analysis. The analysis of best corrected visual acuity (\n                      <jats:styled-content style=\"fixed-case\">BCVA<\/jats:styled-content>\n                      ) Included 26 studies, 20 interventions and 2125 eyes. Heterogeneity was moderate (\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>I<\/jats:italic>\n                        <jats:sup>2<\/jats:sup>\n                      <\/jats:styled-content>\n                      \u2009=\u200928.9%). Non\u2010vitrectomy therapies showed better\n                      <jats:styled-content style=\"fixed-case\">BCVA<\/jats:styled-content>\n                      outcomes and fewer complications (e.g. retinal detachment, vitreous haemorrhage), while vitrectomy\u2010based treatments achieved better anatomical results. According to\n                      <jats:italic>P<\/jats:italic>\n                      \u2010score ranking, \u201cObservation\u201d had the highest probability of being most effective for\n                      <jats:styled-content style=\"fixed-case\">BCVA<\/jats:styled-content>\n                      (\n                      <jats:italic>P<\/jats:italic>\n                      \u2010score\u2009=\u20090.8051), followed by anti\u2010\n                      <jats:styled-content style=\"fixed-case\">VEGF<\/jats:styled-content>\n                      monotherapy and non\u2010vitrectomy combinations. However, this result should be interpreted cautiously, as the \u201cObservation\u201d group was based on only two studies (26 eyes) with clinical heterogeneity. No publication bias was detected (Egger's test\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.582).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      There is no consensus on a standard evidence\u2010based treatment for\n                      <jats:styled-content style=\"fixed-case\">SMH<\/jats:styled-content>\n                      . Minimally invasive strategies are promising, but factors such as timing, lesion size and anti\u2010\n                      <jats:styled-content style=\"fixed-case\">VEGF<\/jats:styled-content>\n                      use remain critical. Further large\u2010scale randomised trials are needed to define optimal management.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/aos.17570","type":"journal-article","created":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T14:30:31Z","timestamp":1754577031000},"page":"139-163","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Interventions for submacular haemorrhage: A systematic review and network meta\u2010analysis of controversies\u2014On behalf of the Spanish Vitreo\u2010Retinal Society (\n                    <scp>SERV<\/scp>\n                    )"],"prefix":"10.1111","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6463-4227","authenticated-orcid":false,"given":"Salvador","family":"Pastor\u2010Idoate","sequence":"first","affiliation":[{"name":"Department of Ophthalmology Clinical University Hospital  Valladolid Spain"},{"name":"Institute of Applied 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