Abstract
Purpose :
Submacular hemorrhage is defined by an accumulation of blood between the neurosensory retina and the retinal pigment epithelium within the macular region. It arises from the choroidal or retinal circulation. Visual prognosis is often mean for these patients.
We gathered all patients who presented to an ophthalmologist in the Hospital of La Rochelle or Poitiers with a diagnosis of submacular hemorrhage during the past 2 years and followed their functional and anatomical results after vitreoretinal surgery.
Methods :
This case series included all patients with a diagnosis of submacular hemorrhage in the Hospital of La Rochelle or Poitiers, during the past two years who underwent vitreoretinal surgery as treatment of their submacular hemorrhage. We registered medical and ophthalmological background for each patient, their treatments, initial visual acuity, clinical characteristic of the submacular hemorrhage and the underlying diagnosis. Postoperative data were registered: visual acuity, anatomical result (persistence of hemorrhage in the posterior pole or in submacular, retinal pigment epithelial tear, atrophy or fibrosis).
Results :
A total of 11 patients underwent vitreoretinal surgery for submacular hemorrhage in the past two years. Mean age at diagnosis was 83,6 years old. In all hemorrhage, five of them were moderate (between 1 and 4 pupillary diameter) and the six others extended beyond temporal arcades. Initial visual acuity was on average 7.7 letters (from “positive light perception” to 60 letters) at diagnosis. All patients had 25-gauge vitrectomy and 81.8% (n = 9) had subretinal injection of tissue plasminogen activator during the surgery.
After 1 month, visual acuity was on average 22.8 letters, hemorrhage was persistent at the posterior pole for 6 patients (60%) and submacular for 2 patients (20%).
Conclusions :
Treatment of submacular hemorrhage, using 25-gauge vitrectomy and subretinal injection of tissue plasminogen activator, dislodge hemorrhage from fovea in about 80% and allows improvement of visual acuity. For all patients, surgical treatment needs to be completed by the etiological treatment.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.