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Gurkan Erdogan, MD
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Gurkan Erdogan, MD, presents an age-related macular disease (AMD) case with subretinal hemorrhage in a patient with sudden vision loss. The subfoveal hemorrhage cases require immediate intervention. There are different treatment options as pneumatic displacement with gas and tissue plasminogen activator. In these methods the patient needs to lie face down firmly and perfect alignment of the gas bubble on the fovea is required. Often it is very difficult for elderly patients. If they can not tolerate face down position, permanent photoreceptor damage can occur. To increase the postoperative patient comfort and success rate, intraoperative displacement of subfoveal hemorrhage using perfluorocarbon is a preferable choice.
Posted: 4/22/2015
Gurkan Erdogan, MD
Gurkan Erdogan, MD, presents an age-related macular disease (AMD) case with subretinal hemorrhage in a patient with sudden vision loss. The subfoveal hemorrhage cases require immediate intervention. There are different treatment options as pneumatic displacement with gas and tissue plasminogen activator. In these methods the patient needs to lie face down firmly and perfect alignment of the gas bubble on the fovea is required. Often it is very difficult for elderly patients. If they can not tolerate face down position, permanent photoreceptor damage can occur. To increase the postoperative patient comfort and success rate, intraoperative displacement of subfoveal hemorrhage using perfluorocarbon is a preferable choice.
Posted: 4/22/2015
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Gurkan Erdogan
10 years ago
I do not have any experience of such an intravitreal manipulation in a non-vitrectomized eye. It may be possible and safe in an old patient with liquefied vitreous. And inferior displacement of the submacular hemorrhage may be possible by the help of the gravitational force and prone position will not be required. No vitrectomy and no prone position. It sounds good. Thank you for your suggestion.
Michele della Corte
10 years ago
You can inject TPA with 23/41 DORC need le without vitrectomy. The patient position will be just seated for 12 Hours
Gurkan Erdogan
10 years ago
I agree with you however we have limited time to displace subfoveal hemorrhage in such cases and time loss may result with permanent photoreceptor damage. Thus future injections may be meaningless. If we are in doubt for the correct positioning after surgery due to reasons related to the patient, vitrectomy seems to be a good choice.
SHALABH SINHA
10 years ago
Did I see a blowout of the fovea while injecting the BSS with the 41 gauge needle? What was the postop OCT like? What percentage of visual gain was seen with this procedure in this patient?
Stanislav Zhuk
10 years ago
removing vitreous will wash out future injected antiVEGF