Pneumatic displacement of subretinal hemorrhage without tissue plasminogen activator.
OBJECTIVE
To assess the efficacy and complications of intravitreal injection of perfluoropropane gas for displacement of subretinal hemorrhage (SRH), without the use of tissue plasminogen activator.


METHODS
Pure perfluoropropane gas (0.4-0.5 mL) was injected into the vitreous cavity in 5 patients with SRH involving the fovea because of age-related macular degeneration (4 eyes) or ruptured retinal arterial macroaneurysm (1 eye). The patients were instructed to maintain a prone position.


RESULTS
Visual acuity ranged from 20/300 to 20/2000 before gas injection. On the day after gas injection, SRH was dramatically displaced in 3 eyes and slightly displaced with a reduction in the thickness of subfoveal hemorrhage in the remaining 2 eyes. Final visual acuity improved in all cases, ranging from 20/15 to 20/220. Three eyes had a final visual acuity of 20/50 or better. Vitreous hemorrhage caused by migration of SRH into the vitreous cavity and retinal detachment each occurred in 1 eye, and both complications were successfully treated by vitrectomy.


CONCLUSIONS
Gas injected into the vitreous cavity can displace SRH without the use of tissue plasminogen activator in some cases. Visual acuity after gas injection may be improved, making this treatment an alternative to evacuation of SRH with vitrectomy.
Ohji
M
M
Department of Ophthalmology, Osaka University Medical School, Suita, Japan. ohji@ophthal.med.osaka-u.ac.jp
Saito
Y
Y
Hayashi
A
A
Lewis
J M
JM
Tano
Y
Y
D000368:Aged; D017542:Aneurysm, Ruptured / Q000150:complications / Q000473:pathology; D005260:Female; D005466:Fluorocarbons / Q000008:administration & dosage*; D005654:Fundus Oculi; D006801:Humans; D008268:Macular Degeneration / Q000150:complications; D008297:Male; D008875:Middle Aged; D016684:Prone Position; D012161:Retinal Artery / Q000473:pathology; D012163:Retinal Detachment / Q000209:etiology / Q000601:surgery; D012166:Retinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D010959:Tissue Plasminogen Activator; D014792:Visual Acuity; D014821:Vitrectomy; D014822:Vitreous Body; D014823:Vitreous Hemorrhage / Q000209:etiology / Q000601:surgery
D005466:Fluorocarbons; C042852:perflutren; D010959:Tissue Plasminogen Activator