@misc{10481/106596,
year = {2025},
month = {8},
url = {https://hdl.handle.net/10481/106596},
abstract = {Purpose: This 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.
Method: A 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.
Results: The 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 (I
2=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).
Conclusions: There 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.},
publisher = {John Wiley & Sons, Ltd.},
keywords = {age-related macular degeneration},
keywords = {anti-vascular endothelial growth factor},
keywords = {pars plana vitrectomy},
title = {Interventions for submacular haemorrhage: A systematic review and network meta-analysis of controversies—On behalf of the Spanish Vitreo-Retinal Society (SERV)},
doi = {10.1111/aos.17570},
author = {Pastor-Idoate, Salvador and Redruello-Guerrero, Pablo and de Juan Hernández, Laura and Benites-Narcizo, Gregorio and Rivera-Izquierdo, Mario and García-Arumí, José and Pastor Jimeno, José Carlos},
}