Characteristics of submacular hemorrhage with bacillary layer detachment and intrabacillary hemorrhage

PurposeTo study the outcomes of patients presenting with submacular hemorrhage (SMH) and bacillary layer detachment (BALAD) following intervention.MethodsThis retrospective study examined fundus photographs and optical coherence tomography (OCT) scans to identify treatment-naive SMH and BALAD cases. Two groups were formed: SMH cases with and without BALAD. The treatment outcomes of these cases were assessed.ResultsThirteen (65%) of the 20 eyes with SMH had BALAD. Blunt trauma was the most common cause of SMH (n = 10, 50%). Median age was 46 years (IQR range: 28-70). Demographic, clinical, or OCT imaging findings between the groups (p > 0.05) were comparable. Nine (45%) patients each underwent intravitreal gas injection alone or along with PPV and TpA injection. At 1-month post-treatment, VA improved (logMAR VA - 0.89; p = 0.017). BALADs and intrabacillary hemorrhage had resolved in eight (61%) cases. Intraretinal, subretinal, and sub-RPE fluids resolved in 100%, 70%, and 43% of cases, respectively. Eyes with resolved BALAD showed greater improvement in VA (logMAR VA - 0.98) than eyes with persisting BALAD (logMAR VA - 1.1) and resulted in significant decrease in central macular (p = 0.016) and retinal thicknesses (p = 0.031). SMH eyes without pre-treatment BALAD also observed statistically significant improvement in visual acuity following intervention (p = 0.031).ConclusionBALAD and intrabacillary hemorrhage in SMH are relatively common. A significant proportion of cases had their BALAD and intrabacillary haemorrhage resolved following treatment. Persistence of BALAD had no effect on VA.