{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:52:29Z","timestamp":1787017949249,"version":"build-2736575974"},"reference-count":32,"publisher":"S. Karger AG","issue":"3","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ophthalmologica"],"published-print":{"date-parts":[[2024]]},"abstract":"<jats:p>&lt;b&gt;&lt;i&gt;Background:&lt;\/i&gt;&lt;\/b&gt; Submacular hemorrhage (SMH) associated with neovascular age-related macular degeneration (nAMD) precipitates rapid visual decline and impacts quality of life. Treatments vary, but combined recombinant tissue plasminogen activator (tPA) and anti-vascular endothelial growth factor (anti-VEGF) therapy has gained prominence as a viable treatment option. &lt;b&gt;&lt;i&gt;Objectives:&lt;\/i&gt;&lt;\/b&gt; This study aimed to evaluate the efficacy of the combination of tPA and anti-VEGF. &lt;b&gt;&lt;i&gt;Methods:&lt;\/i&gt;&lt;\/b&gt; We conducted a systematic review meta-analysis following PRISMA guidelines, focusing on studies examining tPA and anti-VEGF therapy in SMH secondary to nAMD. Outcomes measured were change in best-corrected visual acuity (BCVA) and success rate of SMH displacement. Meta-regression assessed the relative efficacy of intravitreal and subretinal delivery. &lt;b&gt;&lt;i&gt;Results:&lt;\/i&gt;&lt;\/b&gt; Out of 257 initial reports, 22 studies involving 29 patient populations met inclusion criteria. Our analysis showed significant improvement in BCVA and a high rate of successful SMH displacement with combined tPA and anti-VEGF therapy. No significant differences were found between subretinal and intravitreal tPA administration. Furthermore, when evaluating the effects of subretinal versus intravitreal anti-VEGF administration in patients treated with subretinal tPA, the results indicated similar efficacy. &lt;b&gt;&lt;i&gt;Conclusions:&lt;\/i&gt;&lt;\/b&gt; Combined tPA and anti-VEGF therapy is effective in managing SMH in nAMD patients, significantly improving visual acuity and SMH displacement. The location of tPA and anti-VEGF delivery did not significantly impact outcomes.<\/jats:p>","DOI":"10.1159\/000537939","type":"journal-article","created":{"date-parts":[[2024,3,29]],"date-time":"2024-03-29T18:00:26Z","timestamp":1711735226000},"page":"191-202","source":"Crossref","is-referenced-by-count":17,"title":["Submacular Hemorrhage during Neovascular Age-Related Macular Degeneration: A Meta-Analysis and Meta-Regression on the Use of tPA and Anti-VEGFs"],"prefix":"10.1159","volume":"247","author":[{"given":"Daniele","family":"Veritti","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Sarao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Martinuzzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Menzio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Lanzetta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2024,3,29]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1097\/00006982-199616030-00001"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/s0002-9394(14)75575-8"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.survophthal.2015.04.004"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12031035"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/s0950-3536(05)80269-0"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2013.01.012"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-14-45"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1475-1313.2010.00766.x"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7414.557"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.2147\/opth.s8635"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.4274\/tjo.galenos.2020.72540"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jfo.2019.07.002"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.4103\/ijo.IJO_1987_22"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajoc.2022.101390"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1038\/eye.2016.67"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1038\/s41433-019-0720-8"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2023.04.014"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1186\/s40942-020-00228-x"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1097\/IAE.0b013e3181e37884"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.2147\/OPTH.S324091"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1038\/s41433-023-02676-9"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1038\/s41433-022-02222-z"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11082175"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.1097\/APO.0000000000000130"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.14744\/bej.2023.34735"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.3341\/kjo.2016.30.3.192"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-26289-6"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1186\/s12886-022-02639-w"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.4103\/ijo.IJO_1726_21"},{"key":"ref30","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0250587"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2009.164707"},{"key":"ref32","doi-asserted-by":"publisher","DOI":"10.1186\/s13063-021-05966-3"}],"container-title":["Ophthalmologica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/oph\/article-pdf\/247\/3\/191\/4266568\/000537939.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/karger.com\/oph\/article-pdf\/247\/3\/191\/4266568\/000537939.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T11:08:01Z","timestamp":1745406481000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000537939"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024]]},"references-count":32,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2024,8,14]]},"published-print":{"date-parts":[[2024,8,21]]}},"URL":"https:\/\/doi.org\/10.1159\/000537939","archive":["Portico"],"relation":{},"ISSN":["0030-3755","1423-0267"],"issn-type":[{"value":"0030-3755","type":"print"},{"value":"1423-0267","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024]]}}}