PNEUMATIC DISPLACEMENT OF SUBMACULA

HEMORRHAGE WITHOUT TISSUE PLASMINOGEN

ACTIVATOR (tPA)
IRAWADI PUTRA, WENI HELVINDA, KHALILUL RAHMAN
Department Of Ophthalmology, Vitreoretina Subdivision
Faculty Of Medicine, Andalas University, M. Djamil Hospital,
Padang, West Sumatera
INTRODUCTION
Submacular hemorrhage (SMR) is an important cause for acute visual loss. The visual outcome in patients with SMR is
especially poor if the hemorrhage is thick, involves the fovea, covers a large area of the macula and is associated with an
underlying CNVM especially in age related macular degeneration.
OBJECTIVE
To assess the efficacy and complications of intravitreal injection of perfluoropropane gas (C3F8) for displacement of SMR,
without the use of tissue plasminogen activator.

METHODS
A man, 45 years old came to Dr RS. M. Djamil Padang, with left eye could not see
clearly since 21 days ago, sudden blurred, there is no pain, without red eye. On
initial examination, corrected visual acuity was 20/20 OD and hand movement OS.
Anterior segment was within normal limits. Dilated fundus evaluation showed a
large subretinal hemorrhage over the macula in the left eye. Right eye was normal.

RESULT
There is an increase in visual acuity from hand movement before treatment to 2/60
after 2 months of therapy.

CONCLUSION
Therapeutic technique pneumatic displacement in submacula hemorrhage that is not too invasive, simple, and inexpensive
with satisfactory results. Visual acuity after gas injection may be improved, making this treatment an alternative to
evacuation of SMH with vitrectomy. Management of patients rather late patients followed after 21 days after the
hemorrhage submakula appears, this allows neurosensoris retinal layers had permanent damage if more than 7 days after
onset, so the prognosis for visual acuity worse.
KEYWORDS
Submacular hemorrhage (SMR), Pneumatic displacement, perfluoropropane.
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