Pneumatic displacement of submacular haemorrhage

To evaluate the outcomes of pneumatic displacement of submacular hemorrhage secondary to choroidal neovascular membrane (CNV) (n = 9) and retinal arterial macroaneurysm (RAM) (n = 3).

This is a retrospective case series study of 12 eyes from 12 patients in Aberdeen Royal Infirmary, Aberdeen, UK. The mean duration of visual loss was 10.8 ± 4.11 days. All cases received intravitreal injection of expansile gas within 24 h of presentation (C3F8 in 11 cases and SF6 in one case) and postured face down for five days. Anterior chamber paracentesis was done right after gas injection. Intravitreal anti-VEGF was injected at the same time in cases with CNV. Further anti-VEGF injections were done in CNV cases as needed afterwards. Cases were followed up for 6 months.

The submacular hemorrhage was successfully displaced from underneath the fovea in all but one case. The bleeding disappeared totally in 44% of cases and was inferiorly displaced in 56%. VA improvement at 6 months was statistically significantly higher than baseline VA. All cases but 2 (one because of subfoveal fibrosis and one because of late presentation) experienced improved VA. The mean VA improved from 1.37 ± 0.18 logMAR at baseline to 0.83 ± 0.26 logMAR at 6 months. No complication related to the procedure was reported.

Pneumatic displacement of submacular hemorrhage appears to be a safe and effective technique to treat the condition. It is an easy procedure that can be done in outpatient setting. Further studies are needed to validate our results.