THE TIGER STUDY
About the Study
The TIGER study is a pan-European surgical study recruiting patients presenting with bleeds at the back of the eye called submacular haemorrhage (SMH) due to wet age-related macular degeneration (ARMD) diagnosed by an eye doctor. The purpose of the study is to answer the question of whether surgery in the eye and injection of a clot-busting drug called Tissue Plasminogen Activator (TPA) underneath the back of the eye is better than standard of care eye injections of a medication called aflibercept (Eylea®).
For more details about the study, and explanation of the risks and benefits please click on the "About the Study" tab at the top of the page.
What to expect on the Study
If you or a someone you know has been recruited onto the TIGER study, you will already be under the care of an experienced eye surgeon and should have the relevant details about the study, treatments being investigated, and follow up process.
If you have been selected for standard of care eye injections, the first injection may be given to you at the screening/baseline visit or within a week. The exception to this is if you have received an injection within 1 week of being seen for the first TIGER study visit, in which case your first injection will be deferred as you cannot have a repeat injection less than 21 days between injections. Following this visit, you will receive another injection at month 1 and month 2. After that you will be seen by the study team and receive one injection every 2 months until you finish the study follow up period of 12 months. You will receive anaesthetic eye drops to numb the eye before each injection, and may feel a slight pricking sensation with the injection.
If you have been selected for surgery, you will have your first injection at the time of surgery and all subsequent injections at the time points explained above. In the event you have received an injection within 1 week of being seen for the TIGER study, you will still receive an injection at surgery as we will have removed any remaining drug at time of surgery. During surgery we remove the clear gel that fills the inside of the eye and inject a "clot-busting" drug called Tissue Plasminogen Activator (TPA) to dissolve the blood at the back of the eye. We then fill the eye with gas to help push the dissolved blood away from the macula.
After the surgery you will be seen the next day, and at 1 week following the operation, then at the time points above. You need to keep your head tilted forward for 50 minutes of every waking hour for 5 days and should have instructions on how to do this. During the 10 minute breaks you should move around and try to be active, but do not attempt to lift anything heavy and avoid bending or straining. At night you should try to sleep on the side of the surgery, with the operated eye lowest. For example, for Left eye surgery you should sleep with your left cheek to the pillow.
With gas in your eye you should not travel by plane or ascend high altitudes to avoid the gas expanding and causing pressure and pain in the eye.
The gas will disappear from your eye in about 4-8 weeks after surgery.
