Frequency-doubled Nd:YAG laser treatment for premacular hemorrhage

Premacular hemorrhage occurs as a result of Valsalva retinopathy, proliferative diabetic retinopathy, and retinal artery macroaneurysm and may cause sudden, profound visual loss. Currently, it is managed with observation or vitrectomy. An alternative method of treatment is by Nd:YAG laser or argon laser membranotomy. This study investigates the efficacy of frequency-doubled Nd:YAG laser membranotomy.

Twelve patients had frequency-doubled Nd:YAG laser membranotomy as a two-step procedure to drain premacular hemorrhage: two stretch burns to make the membrane stable and taut and then placement of penetration burns between stretch burns. The follow-up period was 18 months.

Ten eyes had marked clearing of hemorrhage and immediate improvement of vision following the laser treatment. One eye with retinal macroaneurysm and another with proliferative diabetic retinopathy did not show marked improvement immediately following membranotomy.

Frequency-doubled Nd:YAG membranotomy is a safe, simple, and noninvasive alternative to conservative treatment or vitrectomy and allows faster resolution of premacular hemorrhage.