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YAG Laser Membranotomy for Subinternal Limiting Membrane Hemorrhage
Min Kim1, Jin Sun Kim, Yuri Seo
1*MD Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Gangnam-gu, Seoul, Korea (MK, JSK, YS); and Institute of Vision Research, Department of Ophthalmology, Severance Hospital, Yonsei University College of Medicine, Seodaemun-gu, Seoul, Korea (HJK, SCL).
Neodymium:yttrium-aluminum-garnet (Nd:YAG) laser internal limiting membranotomy successfully treated a rare subinternal limiting membrane (sub-ILM) hemorrhage. This noninvasive approach resolved the hemorrhage and improved vision after cerebral aneurysm coil embolization.
Area of Science:
- Ophthalmology
- Neurosurgery
- Medical Technology
Background:
- Subinternal limiting membrane (sub-ILM) hemorrhage is a potential complication following cerebral aneurysm coil embolization.
- Central visual disturbances, such as scotoma, can result from sub-ILM hemorrhage.
Observation:
- A 59-year-old woman presented with central vision loss (scotoma) after undergoing stent-assisted coil embolization for an internal carotid artery aneurysm.
- Ophthalmic examination revealed a sub-ILM hemorrhage in her left eye.
Findings:
- A neodymium:yttrium-aluminum-garnet (Nd:YAG) laser internal limiting membranotomy was performed 2 days after symptom onset.
- A single 4.5-mJ Nd:YAG laser burst resulted in marked reduction of the sub-ILM hemorrhage within 1 day.
- Complete resolution of the hemorrhage and visual acuity improvement to 20/20 occurred within 1 month post-procedure.
Implications:
- Nd:YAG laser internal limiting membranotomy presents a viable, noninvasive therapeutic option for sub-ILM hemorrhage post-cerebral aneurysm embolization.
- This technique may offer an alternative to more invasive surgical interventions for this specific ophthalmic complication.
- Highlights the importance of recognizing and managing ocular complications arising from neurointerventional procedures.
