Pietro Rossi MD, Carlandrea Trillo MD, Claudia Castiglioni MD, Angelo Macrì MD, Massimo Corazza MD


To evaluate two different management strategy for thick submacular haemorrhage.


Comparative retrospective interventional non randomized study of 30 consecutive eyes with thick sub-macular haemorrhage secondary to age related macular degeneration. Patients were divided into two groups: group 1 included 17 patients treated with 0,3cc of SF6 injection via pars plana and prone positioning for 4 days; group 2 was composed of 13 patients who underwent pars plana vitrectomy, subretinal recombinant tissue plasminogen activator injection (125 mg/ml) through a translocation microcannula, detachment of the inferior retina followed by fluid–air exchange and no postoperative prone positioning. The end point was the total displacement of the haemorrhage.


The mean follow up time was 4 + 2 months. Total haemorrhage displacement after 1 week was 53% for group 1 and 85% for group 2.


Vitrectomy with subretinal tPA displaced sub-macular haemorrhage faster and more completely than pneumo displacement alone.

Take-home message:

Take away the blood from sub-macular space as soon as possible!! 2 reasons for this: 1 ARMD related haemorrhages: chance to perform PDT in selected cases; 2 non CNV related haemorrhages: the procedure may be curative and associated to good visual prognosis.