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Sub-inner limiting membrane haemorrhage: causes and treatment with vitrectomy
Karolien De Maeyer1, Rita Van Ginderdeuren, Laurence Postelmans
1Department of Ophthalmology, University Hospital Leuven, Katholieke Universiteit Leuven, Belgium.
The British Journal of Ophthalmology
|January 19, 2007
Summary
Sub-retinal basement membrane hemorrhages, often occurring in young patients, cause severe vision loss. Early vitrectomy with inner limiting membrane peeling offers excellent visual recovery with minimal complications.
Area of Science:
- Ophthalmology
- Retinal Surgery
Background:
- Sub-inner limiting membrane (ILM) hemorrhages are often premacular, leading to significant visual impairment.
- These hemorrhages occur in various clinical settings, including Terson's syndrome, Valsalva retinopathy, blood dyscrasia, and blunt facial trauma.
Observation:
- Five patients with suspected sub-ILM hemorrhages underwent early vitrectomy with ILM peeling.
- All patients presented with severe vision impairment due to premacular hemorrhage location.
- Intraoperative confirmation of sub-ILM hemorrhage was achieved using biostaining.
Findings:
- Early pars plana vitrectomy and ILM peeling resulted in excellent visual recovery in all five patients.
- No procedure-related complications were observed.
- Sub-ILM hemorrhages were associated with Terson's syndrome, Valsalva retinopathy, blood dyscrasia, and blunt facial trauma.
Implications:
- Early surgical intervention for sub-ILM hemorrhages is justified when spontaneous resorption is insufficient.
- Vitrectomy with ILM peeling is a safe and effective treatment for sub-ILM hemorrhages.
- This approach leads to excellent visual outcomes in patients with severe visual impairment.
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