Real-world outcomes and complications of different surgical approaches for significant submacular haemorrhages

Purpose: To evaluate the outcomes and complications after different surgical management of cases with significant sumacular hemorrhage (SMH) of size more than 4 disc diameter (DD). Methods: It was a retrospective interventional study. All consecutive 103 cases of significant SMHs were treated by vit...

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Bibliographic Details
Published in:Indian journal of ophthalmology 2023-05, Vol.71 (5), p.2045-2052
Main Authors: Boral, Subhendu, Agarwal, Deepak, Das, Arnab, Chakraborty, Debdulal, Mandal, Santanu
Format: Article
Language:English
Subjects:
180-degree retinectomy
Acuity
autologous rpe-choroid patch graft transplantations
Care and treatment
Complications
Complications and side effects
Computed tomography
Epithelium
Eye diseases
Fibrinolytic Agents - therapeutic use
Hemorrhage
Humans
Original
Photopigments
Postoperative
Retina
Retinal Hemorrhage - diagnosis
Retinal Hemorrhage - etiology
Retinal Hemorrhage - surgery
Retinal pigment epithelium
Retrospective Studies
Silicones
submacular hemorrhage
subretinal rt-plasminogen activator (pa)
t-Plasminogen activator
Tamponade
Tissue Plasminogen Activator
Treatment Outcome
Vitrectomy - methods
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Summary:Purpose: To evaluate the outcomes and complications after different surgical management of cases with significant sumacular hemorrhage (SMH) of size more than 4 disc diameter (DD). Methods: It was a retrospective interventional study. All consecutive 103 cases of significant SMHs were treated by vitrectomy and divided into three groups. In Group A (8 weeks, extending beyond macula, n = 10), SMH removal with autologous retinal pigment epithelium (RPE)-Choroid patch graft transplantations with SO tamponade were performed. Parameters evaluated were best corrected visual acuity (BCVA), Optos, optical computerized tomography, and ultrasonography as required. Results: Significant visual improvement was seen from mean preoperative to mean postoperative BCVA in Group A (P < 0.001), Group B (P < 0.001), and Group C (P < 0.001). Postoperative complications were recurrent SMH (4.84% vs 12.90% vs 10%), vitreous hemorrhage (6.45%, GroupA), hyphema (4.84% vs 12.90% vs 10%), hypotony (nil vs 3.23% vs 20%), macular hole formation (6.45%, Group A), epiretinal membrane (16.13%, Group B), and retinal detachment (3.23%, Group A and 10%, Group C). Conclusion: Surgical approaches for significant submacular hemorrhage are visually awarding, though certain specific complications may arise.
ISSN:0301-4738
1998-3689
DOI:10.4103/ijo.IJO_1987_22