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Related Experiment Video

Updated: Oct 5, 2025

A Step by Step Protocol for Subretinal Surgery in Rabbits
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TREATMENT OPTIONS FOR PREMACULAR AND SUB-INTERNAL LIMITING MEMBRANE HEMORRHAGE.

M Kováčová, B Kousal, M Meliška

    Ceska a Slovenska Oftalmologie : Casopis Ceske Oftalmologicke Spolecnosti a Slovenske Oftalmologicke Spolecnosti
    |January 27, 2022
    PubMed
    Summary

    Premacular hemorrhage (PH) and sub-internal limiting membrane hemorrhage (sub-ILM-H) impact vision. Treatments like Nd: YAG laser hyaloidotomy and vitrectomy with ILM peeling effectively improved visual acuity and retinal findings in patients.

    Keywords:
    25-Gauge vitrectomyNd:YAG laser hyaloidotomyhistologyhistopathologyhistopatologyinternal limiting membranepremacular hemorrhageultrastructural morphometry

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    Area of Science:

    • Ophthalmology
    • Retinal Surgery
    • Medical Retina

    Background:

    • Premacular hemorrhage (PH) and sub-internal limiting membrane hemorrhage (sub-ILM-H) are significant causes of sudden central visual acuity deterioration.
    • These conditions necessitate evaluation of various therapeutic options for anatomical and functional recovery.

    Purpose of the Study:

    • To retrospectively evaluate the anatomical and functional outcomes of different therapeutic interventions for premacular hemorrhage and sub-internal limiting membrane hemorrhage.
    • To assess the efficacy of Nd: YAG laser hyaloidotomy and vitrectomy with internal limiting membrane (ILM) peeling.

    Main Methods:

    • Retrospective analysis of three patients (2 female, 1 male) with PH or sub-ILM-H.
    • Hemorrhage location confirmed via spectral domain optical coherence tomography (SD-OCT).
    • Treatment modalities included conservative management, Nd: YAG laser hyaloidotomy, and 25-Gauge vitrectomy with ILM peeling and histopathological examination.

    Main Results:

    • All patients achieved improvement in best corrected visual acuity (BCVA) and retinal findings.
    • Final BCVA ranged from 0.8 to 1.0.
    • Histopathological examination of ILM revealed variable thickness and the presence of fibroblasts and macrophages with hemosiderin deposits.

    Conclusions:

    • Treatment choice for PH and sub-ILM-H depends on BCVA, hemorrhage extent/location, and patient health.
    • Nd: YAG laser hyaloidotomy offers rapid visual recovery.
    • Surgical ILM peeling effectively removes hemorrhage breakdown products and minimizes secondary epiretinal membrane formation.