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G. Reategui-Escalante, J. Dalma-Weiszhausz., V. Morales-Canton, S. Murillo-Lopez, L. Suarez-Tata, M. Turati; Pneumodisplacement of Submacular Hemorrhage Secondary to Traumatic Choroidal Rupture . Invest. Ophthalmol. Vis. Sci. 2003;44(13):1856.
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Purpose: To assess the efficacy and safety of using sulfur hexafluoride (SF6) injected intravitreally to induce pneumodisplacement of submacular hemorrhage secondary to traumatic choroidal rupture Methods: A prospective, non-comparative longitudinal case series was conducted including patients with submacular hemorrhage secondary to traumatic choroidal rupture. Complete ocular examination, best corrected visual acuity, fluoroangiography (FAG), multifocal electroretinogram (mERG), ocular coherence tomography (OCT) and automated visual field test were performed prior to gas injection. Under topical anesthesia 0.4 ml of 100% SF6 were injected intravitreally via pars plana in the superotemporal quadrant using a 27 gauge needle. All patients were positioned face-down for 24 hours. Follow-up visits were done at 48 hours, 2, 4 and 12 weeks after injection. Ophthalmologic examination, best corrected visual acuity, FAG, mERG and OCT were performed at each visit. Results: Eight eyes of eight consecutive patients were included in the study. Average age was 26.88 years (SD± 8.1), five patients were males and three were females. Choroidal rupture was clinically and angiographically diagnosed in all cases. Interval of time between the trauma and the procedure ranged between 1-15 days (average 6.88 days) and 62.5% of the cases were treated within the first five days. Average diameter of the hemorrhage measured in disc diameters was 4.83 DD (SD ± 2.39). Six patients (75%) improved visual acuity within 48 hours of the procedure; one (12.5%) was stabilized and one (12.5%) decreased. A total displacement of the submacular hemorrhage was shown by OCT. mERG and campimetry showed improvement in photoreceptor function and reduction of scotomata .Gross correlation between the extent and location of choroidal rupture and campimetric defect was present but unpredictable. All patients showed effective displacement of the submacular hemorrhage within the first 48 hours. Conclusions: Pneumodisplacement of submacular hemorrhage seems to be a safe, effective and less invasive therapeutic alternative for this condition, leading to anatomic and visual acuity improvement demonstrated by clinical, tomographic and functional evaluation.
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