Subretinal tPA+ Subretinal Pneumatic Displacement of Large Submacular Hematomas



Large submacular haemorrhage poses a serious threat to vision. The aetiology of sub macular haemorrhage is diverse. The presentation reports on five cases with large sub macular haematomas seriously affecting vision. Two eyes were post traumatic, one idiopathic and two secondary to AMD. Parsplana vitrectomy was performed followed by sub retinal injection of 75-100ug of Tpa using 41g cannula. This is followed by sub retinal injection of air. Fluid air change was then done leaving the patient in the prone position for the first 24 hours. The procedure was successful in clearing the sub macular space in all cases with marked improvement in visual performance depending on the original pathology. No severe adverse effects were noted.


Submacular Tpa + sub macular air injection is a useful technique to treat large sub macular haematomas.



Mahmoud Soliman
Cairo, Egypt
Email :
Cell Phone: +201223112302
Work Phone: +20233472706