Case Reports in Ophthalmological Medicine
Traumatic Submacular Hemorrhage with Macular Hole Repaired by Pneumatic Displacement and Intravitreal t-PA Injection
A 27-year-old male with no past medical history presented to the Emergency Department after sustaining blunt trauma to his right eye secondary to an airbag injury. Visual acuity measured 20/400 in the affected eye. Funduscopic examination demonstrated an arcuate choroidal rupture inferior to the optic nerve and subretinal hemorrhage extending from the optic nerve into the fovea.
Complications of ocular trauma include subretinal hemorrhage, macular hole, CNV, retinal detachment, and other potentially sight-threatening conditions. SMH is a potential visually devastating condition, most commonly associated with CNV due to AMD [1, 5, 6]. Subretinal blood and blood products damage retinal tissues through the toxic effects of iron, hemosiderin, and brin on the overlying photoreceptors. In addition, clot retraction can sheer and damage the photoreceptors while the physical separation of the photoreceptors from the RPE can lead to profound reti- nal dysfunction [1, 2, 5]. Management of SMH has been described using multiple approaches alone or in combination with varying success including observation, PPV, pneumatic displacement, t-PA, and anti-VEGF [4–6].