Pneumatic Displacement of Submacular Hemorrhage


ABSTRACT

Advantage:

Pneumatic displacement of large submacular hemorrhage in hemorrhagic AMD (and similar conditions) using intraocular injection of C3F8 leads to a fast relief, enables blood reabsorption and opens the way to the continuation of AMD treatment. We do not use any additional medicaments as TPA but continue with anti-VEGF therapy in most cases.

Method:

The pneumatic displacement was used 12 times (in one eye twice) in a group of 11 eyes of 11 patients (5 male, 6 female). The mean age of our patients was 76 years (65 to 96). All eyes but one suffered from AMD; one eye had submacular hemorrhage after the ERM peeling. The mean hemorrhage area was 15 DA (4 to 25). The mean duration of hemorrhage was 6.5 days (1 to 14). All eyes received 0.3 ccm of C3F8 followed with downgaze within several days afterwards. All but two patients continued with anti-VEGF injections; one eye underwent direct laser coagulation of peripapillary CNV.

Effectiveness / Safety:

In all cases the blood completely reabsorbed. The VA improved noticeably in four patients, in two eyes VA improved less significantly. In five patients the vision slightly worsened due to GA or fibrosis. In one patient with a large central fibrosis and extrafoveal bleeding, the VA did not change. The mean VA improved from 0.2 (0.01 to 0.6) to 0.4 (0.05 to 0.9). The mean follow-up was 15 months (1 to 50). The functional result was not much influenced by the duration of hemorrhage but rather by the etiopathogenesis (RPE rupture, large fibrosis or GA had poorer visual prognosis). We did not observe any complications of the gas injection.

Take Home Message:

Submacular hemorrhages can successfully be treated using pure C3F8 injections.


CONTACT DETAILS

 

Ivan Fiser
Prague, Czech Republic
Email : fiser@lexum.cz
Cell Phone: +420775203219
Work Phone: +420244016481