We thank Schaal and associates for their interest in our article and we appreciate their comments. In our study, we included patients with hemorrhage of various durations and did not perform subgroup analysis of hemorrhage duration, partly owing to the relatively small numbers in each group, and partly because it was difficult to consistently ascertain hemorrhage duration based on the patient’s history. However, in our series, patients with hemorrhage present for greater than 1 month who had vitrectomy with subretinal tissue plasminogen activator (t-PA) still had both anatomic and visual improvement. We agree that the other factors, such as depth/extent of the hemorrhage and location of the underlying choroidal neovascular membranes, could also affect outcomes. We did not specifically examine these variables as the data were variably present and/or difficult to reliably assess.
We only included patients who underwent vitrectomy with subretinal t-PA and pneumatic displacement, and focused on the role of subsequent anti–vascular endothelial growth factor (VEGF) therapy. Schaal and associates bring up an important point, as there is not much in the literature to support how the technique we used compares to pneumatic displacement with intravitreal injection of t-PA. We look forward to reading about their results, which will hopefully help refine the way we treat patients.