http://www.evrs.eu/medias/2005/congress/Management-of-sub-macular-haemorrhage.swf

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

Purpose:

To evaluate two different management strategy for thick submacular haemorrhage.

Methods:

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.

Results:

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.

Conclusion:

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.