Dr. Vinay Prasad, P11758, Dr. Nishikant Borse
Submacular hemorrhage damages tissue through a variety of mechanisms: The presence of iron, hemosiderin and fibrin in the blood has toxic effects on the overlying photoreceptors; clot retraction can sheer and damage the photoreceptors; and finally, physical separation of the photoreceptors from the RPE causes both to atrophy and can result in disciform scar formation.
In our series of 3 cases , 1 case of traumatic submacular hemorrhage was managed by pneumatic displacement with Tpa and Anti-Vegf. the 2nd case involved an active CNVM , which was surgically treated with subretinal injection of T-Pa and low IOP vitrectomy and partial FGE. The 3rd case of IPCV involving extensive sub retinal bleed with SMH was treated with 360 degree retinectomy and drainage of SMH and silicon oil injection.
Thus we conclude that depending on the cause of sub macular hemorrhage the treatment approach should be customised to achieve the optimum results.