scholarly journals Suprachoroidal Gas: A Rare Complication of Intravitreal Injection of Perfluoropropane

2021 ◽  
pp. 894-898
Author(s):  
Liana Dedina ◽  
Wilson Wong ◽  
Shane Durkin
Keyword(s):  
Case Report ◽  
Intravitreal Injection ◽  
Rare Complication ◽  
Age Related Macular Degeneration ◽  
Submacular Hemorrhage ◽  
Current State ◽  
Age Related ◽  
Pneumatic Displacement ◽  
Plausible Mechanism ◽  
Gas Entrapment

This is a case report of a 75-year-old pseudophakic male, who presented with a massive submacular hemorrhage on a background of neovascular age-related macular degeneration. Intravitreal perfluoropropane was used to attempt pneumatic displacement of the submacular hemorrhage. The next day, subconjunctival gas was observed, with no gas seen in the vitreous cavity. Fundal examination showed suprachoroidal detachment. CT images confirmed gas entrapment, with no choroidal hemorrhage identified. The following case report describes suprachoroidal gas as a complication of intravitreal injection of perfluoropropane for pneumatic displacement of submacular hemorrhage. To our knowledge, this is the first such case in the literature. We describe the approach in differentiating suprachoroidal gas from hemorrhage and comment on a plausible mechanism for this complication. This report also serves as a review of the current state of knowledge in the area of suprachoroidal gas as a complication of pneumatic retinopexy and sutureless vitrectomy.

scholarly journals Management of a Submacular Hemorrhage Secondary to Age-Related Macular Degeneration: A Comparison of Three Treatment Modalities

2020 ◽  
Vol 9 (10) ◽  
pp. 3088
Author(s):  
Seongyong Jeong ◽  
Dong-Geun Park ◽  
Min Sagong
Keyword(s):  
Macular Degeneration ◽  
Age Related Macular Degeneration ◽  
Treatment Modalities ◽  
Submacular Hemorrhage ◽  
Visual Improvement ◽  
Anti Vegf ◽  
Age Related ◽  
Pneumatic Displacement ◽  
Invasive Techniques ◽  
Endothelial Growth Factor

This paper aims to compare the effects of three treatment modalities for a submacular hemorrhage (SMH) secondary to exudative age-related macular degeneration (AMD). Seventy-seven patients with an SMH were divided into three groups: small-sized (optic disc diameter (ODD) ≥ 1 to < 4), medium-sized (ODD ≥ 4 within the temporal arcade) and large-sized (ODD ≥ 4, exceeding the temporal arcade). Patients received anti-vascular endothelial growth factor (anti-VEGF) monotherapy, pneumatic displacement (PD) with anti-VEGF or a vitrectomy with a subretinal tissue plasminogen activator (tPA) and gas tamponade based on the surgeon’s discretion. The functional and anatomical outcomes were evaluated. Among the 77 eyes, 45 eyes had a small-sized, 21 eyes had a medium-sized and 11 eyes had a large-sized SMH. In the small-sized group, all treatment modalities showed a gradual best-corrected visual acuity (BCVA) improvement with high hemorrhagic regression or displacement rates (over 75%). In the medium-sized group, PD and surgery were associated with better BCVA with more displacement than anti-VEGF monotherapy (67% and 83%, respectively, vs. 33%). In the large-sized group, surgery showed a better visual improvement with a higher displacement rate than PD (86% vs. 25%). Our findings demonstrated that visual improvement can be expected through appropriate treatment strategy regardless of the SMH size. In cases with a larger SMH, invasive techniques including PD or surgery were more advantageous than anti-VEGF monotherapy.

scholarly journals Visual Outcome after Vitrectomy with Subretinal tPA Injection to Treat Submacular Hemorrhage Secondary to Age-Related Macular Degeneration or Macroaneurysm

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Yasmin Ali Said ◽  
Evelien Dewilde ◽  
Peter Stalmans
Keyword(s):  
Visual Acuity ◽  
Surgical Approach ◽  
Retinal Pigment ◽  
Visual Outcome ◽  
Underlying Disease ◽  
Age Related Macular Degeneration ◽  
Submacular Hemorrhage ◽  
Randomized Controlled Studies ◽  
Age Related ◽  
Pneumatic Displacement

Purpose. To determine the efficacy and safety of 23G transconjunctival sutureless vitrectomy, subretinal injection of tissue plasminogen activator using the EVA Surgical System, and pneumatic displacement with air to treat submacular hemorrhages. Methods. Retrospective analysis of 93 eyes surgically treated for submacular hemorrhage caused by neovascular AMD or retinal macroaneurysms. Main Outcome Measures. Postoperative visual acuity and surgical complications. Results. After surgery, visual acuity improved after 6 weeks but decreased again at the final postoperative visit at 8 months due to progression of the underlying disease. Complications consisted of 2 cases of retinal pigment epithelial tear, 7 vitreous hemorrhages, 4 hyphema, 6 cases of retinal detachment, and 2 subchoroidal hemorrhages during the follow-up period. Conclusions. This study suggests that a surgical approach with 23G vitrectomy, subretinal tPA injection, and pneumatic displacement using air may be an effective procedure for submacular hemorrhage displacement in patients with AMD and retinal macroaneurysms. However, visual outcome is limited by the underlying macular pathology. Larger multicenter randomized controlled studies are warranted to determine the therapeutic effect of this surgical approach.

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