VT175 : Despair Deep Down Under – Surgical evacuation of massive Subretinal haemorrhage

Dr.Anand Rajendran

A 58 year old male presented with reduced vision in the right eye of 5 days duration. Best corrected vision (BCV) was 1/60 OD ; 6/9 OS with large fresh Submacular hemorrhage (SMH) extending to the periphery . OCT highlighted large SMH, PEDs. FFA ,ICG confirmed PCV. Intravitreal Ranibizumab (0.5mg) was given. A week later, vitreous haemorrhage was noted. 23 G vitrectomy was performed. Temporal to the arcades, with a 40 G pipette attached to syringe infusion, multiple localised RDs were created. A curvilear retinectomy in equatorial retina with vitrectomy probe was done. Submacular hemorrhage,were evacuated with cutter and soft silicone tip aspirator. Laser barrage, Fluid-air exchange was followed by Silicone oil infusion. 2 weeks later, the patient had 6/60 BCV, well attached retina with negligible staining of a flat macula. 6 months later, BCV was 6/18 with clear, flat macula; attached retina. OCT showed reduced elevation of the RPE and ICG/FFA showed inactivity of the pathology.