{
  "abstract": "Background: To evaluate the safety, anatomical and visual outcomes, and prognostic factors of pars plana vitrectomy (PPV) with subretinal tenecteplase (TNK-tPA) injection and gas tamponade for submacular hemorrhage (SMH) secondary to polypoidal choroidal vasculopathy (PCV).\n\nMethods: In this retrospective case series, 10 eyes of 10 consecutive patients with PCV and fovea-involving SMH (>5 disc areas) underwent 25-gauge PPV, subretinal TNK-tPA injection (50 μg/0.05 mL at a single site in 7 eyes; multi-site injection totaling up to 100 μg in 3 eyes), and tamponade with 0.4 mL of pure C₃F₈ gas, followed by pro re nata anti-vascular endothelial growth factor (anti-VEGF) therapy. Best-corrected visual acuity (BCVA), central macular thickness (CMT), pigment epithelial detachment (PED), anti-VEGF treatment burden, and complications were evaluated over 12 months.\n\nResults: Complete subfoveal hemorrhage displacement was achieved in all eyes (100%) by postoperative day 1. At 12 months, median BCVA improved from 1.25 (IQR, 1.10–1.70) to 0.30 (IQR, 0.23–0.95) logMAR (Z = −2.617, P = 0.010), and mean CMT decreased from 1,006.0 ± 183.0 μm to 205.9 ± 48.2 μm (t = 12.44, P < 0.001). PED resolved in 90.0% of eligible eyes by month 2, with a mean of 1.8 anti-VEGF injections. The 12-month BCVA correlated with time to surgery (r = 0.84, P = 0.002) and hemorrhage area (r = 0.87, P = 0.001); given the strong collinearity between these variables (r = 0.918) and the small sample size, these associations are exploratory and hypothesis-generating. No TNK-tPA–related adverse events were observed.\n\nConclusions: PPV with subretinal TNK-tPA injection and gas tamponade was associated with rapid hemorrhage displacement, visual improvement, and an observed mean of 1.8 anti-VEGF injections over 12 months in this small PCV cohort. Better visual outcomes were associated with shorter time to surgery and smaller hemorrhage area; these associations are exploratory given the observational design and the strong collinearity between these two factors. Larger controlled studies are needed to confirm safety and comparative effectiveness.",
  "abstract_shown": true,
  "affiliations": [
    "Jinan University , ,",
    "Chongqing Nanping Aier Eye Hospital , ,"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 6,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ling Ai"
    },
    {
      "affs": [
        1
      ],
      "name": "Xindan Meng"
    },
    {
      "affs": [
        1
      ],
      "name": "Shan He"
    },
    {
      "affs": [
        1
      ],
      "name": "Shiman Yuan"
    },
    {
      "affs": [
        1
      ],
      "name": "Yixia Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Yi Wang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bgmga76yzz57r.bib",
  "cited_by": 0,
  "doi": "10.3389/fmed.2026.1981363",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13727473/?tool=EBI",
  "id": "bgmga76yzz57r",
  "issns": [
    "2296-858X"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13727473",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Original Research"
    ],
    [
      "openalex",
      "2741|Retinal and Macular Surgery"
    ]
  ],
  "openalex": "W7223053184",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13727473/pdf/?tool=EBI",
  "pmcid": "PMC13727473",
  "pmid": "42978589",
  "published": "2026-10-20",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/bgmga76yzz57r.ris",
  "sources": [
    {
      "first_seen": "2026-11-04T15:20:45Z",
      "native_id": "PMC:PMC13727473",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13727473"
    },
    {
      "first_seen": "2026-11-06T12:23:20Z",
      "native_id": "PMC13727473",
      "source": "pmc",
      "url": "https://doi.org/10.3389/fmed.2026.1981363"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2741|Retinal and Macular Surgery",
      "subfield": "imaging"
    }
  ],
  "title": "Twelve-month outcomes of subretinal tenecteplase-assisted vitrectomy for large submacular hemorrhage secondary to polypoidal choroidal vasculopathy: a retrospective consecutive case series",
  "title_text": "Twelve-month outcomes of subretinal tenecteplase-assisted vitrectomy for large submacular hemorrhage secondary to polypoidal choroidal vasculopathy: a retrospective consecutive case series",
  "type": "peer-reviewed",
  "updated_at": "2026-11-07T12:20:39Z",
  "url": "https://research.draconitic.com/paper/bgmga76yzz57r",
  "venue": "Frontiers in medicine",
  "versions": []
}