Turkish Abstract Abstract Article PDF Similar Articles Mail to Author

Beyoğlu Göz Eğitim ve Araştırma Hastanesi, İstanbul Case Report: Sixtyseven years old female patient was admitted with the complaint of loss of visual acuity on the left eye, since 1 week. She had a history of loss of visual acuity on the right eye since 5 years. In her ophthalmological examination, the visual acuities were counting fingers from 30 centimeters temporally on the right eye, and counting fingers from 1 meters on the left. On theslit-lamp examination, pseudophakia and posterior synechia on the right eye, grade 1 nuclear sclerosis on the left eye were detected. Intraocular pressure was measured as 16 mmHg and 17 mmHg on the right and left eyes, respectively, by applanation tonometry. Fundoscopy revealed disciform scar formation due to age related macular degeneration on the right eye, while subretinal hemorrhage of 2 disc diameters on the left. The thickness of the hemorrhage prevented the visualisation of underlying pathology. Fluorescein angiography (FA) and optical coherence tomography (OCT) were done. As for the treatment approach; pars plana vitrectomy, subretinal tPA injection and pneumatic displacement with intravitreal gas tamponade were performed. On the postoperative 1st day, subretinal hemorrhage was detected to be totally displaced from the macular area. Postoperatively, the visual acuity of the patient improved to counting fingers from 3 meters on the 3rd day, to 0.1 on the 2nd month. The FA on the 1st month revealed occult membrane formation, and photodynamic therapy (PDT) was planned. In conclusion, in submacular hemorrhage cases, vitrectomy with subretinal t-PA is an efficient method for the displacement of the hemorrhage and early treatment of the primary pathology. Keywords : Submacular hemorrhage, subretinal t-PA, pneumatic displacement