J Korean Ophthalmol Soc.  2012 Nov;53(11):1630-1636.

Clinical Course of Submacular Hemorrhage Due to Various Chorioretinal Diseases According to Pneumatic Displacement

• Kim DW
• Feng CS
• Bae SH
• Kim HK
• Nam WH

Abstract

PURPOSE
To assess the clinical course of submacular hemorrhage (SMH) due to various chorioretinal diseases with or without pneumatic displacement and the factors related with the final visual outcome.
METHODS
The authors of the present study retrospectively reviewed the charts of 12 eyes (group 1) which underwent pneumatic displacement for SMH and the charts of 14 eyes (group 2) which did not receive pneumatic displacement. Best-corrected visual acuity (BCVA) at baseline was compared with the BCVA at 1, 3, and 6 months and on the final visit. Association between final BCVA and other clinical features was analyzed including age, baseline BCVA, duration of symptoms, and size of SMH.
RESULTS
In group 1, log MAR BCVA was 1.22 +/- 0.66 at baseline and there was a significant BCVA improvement of 0.77 +/- 0.57 at 6 months compared with baseline (p = 0.045). On the final visit, 6 eyes (50%) had gained 2 Snellen lines or more. In group 2, BCVA was significantly improved from 1.29 +/- 0.70 at baseline to 1.06 +/- 0.84 at 1 month (p = 0.045). Ten eyes (71.4%) had gained 2 Snellen lines or more on the final visit. In group 1, there were no factors correlated with final BCVA (p > 0.05), while the final BCVA was significantly correlated with age and baseline BCVA in group 2.
CONCLUSIONS
Clinicians may expect conservative treatment to lead to significant improvement of BCVA in patients with SMH due to various chorioretinal diseases who did not undergo any procedures to displace the hemorrhage.

Keyword

Conservative treatment; Pneumatic displacement; Submacular hemorrhage

MeSH Terms

Displacement (Psychology)
Eye
Hemorrhage
Humans
Retrospective Studies
Visual Acuity

Figure

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  Figure 1 The change of visual acuity in pneumatic group (A) and observation group (B). In the pneumatic group, visual acuity was improved significantly at 6 months after gas displacement compared with baseline (p=0.045). In the observation group, visual acuity improved significantly at each follow-up visit (p=0.045, p=0.003, p=0.002, p=0.003, respectively). *For p-value of less than 0.05.

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  Figure 2 A case of a 73-year old man with age-related macular degeneration. The changes of his visual acuity (log MAR) were as follows; 0.52 at baseline, 0.7 at 1 month, 0.7 at 3 months, and 0.4 at 6 months after intravitreal gas injection of perfluoropropane. (A) Baseline fundus photograph showed an extensive submacular hemorrhage covering the fovea. (B) One month after gas injection, the subretinal hemorrhage was partially dissolved. (C) Three months later, it showed nearly complete dissolution of the submacular hemorrhage and appearance of subfoveal fibrosis. (D) Six months later, the submacular hemorrhage was completely disappeared but it left subfoveal scarring.

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  Figure 3 A case of a 18-year old man with traumatic choroidal rupture. His log MAR visual acuity improved from 0.52 at baseline to 0.22 at 6 months with conservative treatment. (A) Baseline fundus photograph showed a submacular hemorrhage involving the fovea center. (B) Six months after conservative treatment, the submacular hemorrhage completely disappeared but left a macular scar.

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