Perfluorohexyloctane endotamponade for treatment of subfoveal hemorrhage.
OBJECTIVE
To report on the use of perfluorohexyloctane as a heavy liquid to temporarily tamponade the fovea for the prevention of recurrent massive subfoveal hemorrhage in patients with exudative age-related macular degeneration (ARMD).


METHODS
The case series comprised seven patients with acute massive subfoveal hemorrhage due to exudative ARMD. The patients underwent pars plana vitrectomy, drainage of the subretinal blood, and foveal endotamponade with perfluorohexyloctane. The perfluorohexyloctane was removed 80.4 +/- 38.1 days (median 98 days; range 22-118 days) after the primary surgery in a second pars plana intervention.


RESULTS
In six patients (85.7%) the subretinal hemorrhage removed during the first pars plana vitrectomy did not recur after removal of perfluorohexyloctane. In the seventh, however, a subretinal hemorrhage re-developed five days after release of perfluorohexyloctane. No large epiretinal membranes were observed. In six eyes (85.7%), the retina remained attached after removal of perfluorohexyloctane but in one eye proliferative vitreoretinopathy developed, with central retinal detachment. After the first pars plana vitrectomy, visual acuity increased slightly but not significantly (p = 0.25), from 0.03 +/- 0.03 to 0.05 +/- 0.07. Intraocular pressure rose from 15.0 +/- 1.9 mm Hg to 24.9 +/- 16.9 mm Hg. After a follow-up of 69.7 +/- 121.0 days after removal of the perfluorohexyloctane, final visual acuity was 0.02 +/- 0.04.


CONCLUSIONS
Perfluorohexyloctane may be a useful additional tool for preventing the recurrence of subfoveal re-bleeding in exudative ARMD.
Jonas
J B
JB
Department of Ophthalmology and Eye Hospital, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Mannheim, Germany. Jost.Jonas@augen.ma.uni-heidelberg.de
Jager
M
M
D000368:Aged; D000369:Aged, 80 and over; D005466:Fluorocarbons / Q000627:therapeutic use*; D005584:Fovea Centralis; D006801:Humans; D008268:Macular Degeneration / Q000150:complications / Q000188:drug therapy; D012166:Retinal Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D055502:Secondary Prevention; D014792:Visual Acuity; D014821:Vitrectomy
D005466:Fluorocarbons; C118616:perfluorohexyl-octan