title: Submacular hemorrhage: a study amongst Indian eyes.
abstract: OBJECTIVE
  To evaluate the management outcomes amongst various treatment modalities for submacular hemorrhage (SMH) in Indian subjects.
  
  
  METHODS
  Retrospective, single-center study.
  
  
  METHODS
  Patients presenting with SMH between 1999 and 2006 were included. Treatment modalities included: vitrectomy with subretinal recombinant tissue plasminogen activator (r-tPA) assisted SMH evacuation (group 1, n = 14); pneumatic displacement with intravitreal r-tPA and gas (group 2, n = 25); and pneumatic displacement with intraocular gas (group 3, n = 7). Favorable anatomical outcome was defined as complete displacement of SMH from fovea and favorable functional outcome was defined as a gain of >2 Snellen lines from the baseline. Kruskal-Wallis, analysis of variance (ANOVA), and Chi-square tests were used to compare the three groups, while Mann-Whitney and independent t-test were used to evaluate the influence of duration and size of SMH on outcomes.
  
  
  RESULTS
  There was no difference amongst groups in terms of favorable anatomical (P = 0.121) or functional outcomes (P = 0.611). Eyes with median duration of SMH less than 7.5 days had a significantly higher probability of achieving favorable anatomical outcome compared to eyes with SMH >14.5 days (P = 0.042). However, duration of SMH did not influence functional outcome (P = 0.595). Similarly, size of SMH did not affect anatomical (P = 0.578) or functional (P = 0.381) outcome. Median follow-up was 31.5, 6.5, and 2.5 months in the three groups, respectively.
  
  
  CONCLUSIONS
  Co- existing posterior segment conditions and duration of SMH may influence the choice of treatment modality and treatment outcomes. Pneumatic displacement with r-tPA and r-tPA assisted vitrectomy appear to be favorable options for the management of SMH.
authors.affiliation: Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India.
authors.forename: Ekta
authors.initials: E
authors.lastname: Rishi
authors.forename: Lingam
authors.initials: L
authors.lastname: Gopal
authors.forename: Pukhraj
authors.initials: P
authors.lastname: Rishi
authors.forename: Sabyasachi
authors.initials: S
authors.lastname: Sengupta
authors.forename: Tarun
authors.initials: T
authors.lastname: Sharma
mesh_terms: D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007267:Injections; D008297:Male; D008875:Middle Aged; D012160:Retina; D012166:Retinal Hemorrhage / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D012189:Retrospective Studies; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome; D014821:Vitrectomy / Q000379:methods*
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator