First Author: P.B.Gowda INDIA
Co Author(s): V. Kadri N.K. Yadav R. Shetty 0 0 0 0 0 0 0 0 0
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To examine the clinical outcome of pneumatic displacement of submacular hemorrhage secondary to recent and old blunt trauma
Narayana Nethralaya Bangalore, India
An interventional case series of three patients who presented with decreased vision and submacular hemorrhage following blunt trauma. Complete ophthalmic examination including best corrected visual acuity(BCVA), intraocular pressure measurement(IOP), dilated fundus examination and OCT was done. All the three patients were treated with intravitreal injection of 0.3cc of 100% C3F8 with anterior chamber paracentesis. Strict prone position was advised for 2 weeks. Documentation was done with serial fundus photographs and OCT pre and post intervention
The age/sex of the patients were 46years/M, 32years/F and 19years/M. The first patient presented 2 days post trauma, second presented at 3 weeks and the third presented 5 days post trauma.The best corrected visual acuities at presentation were CF 1 m, CF 2.5 m and 6/60 respectively. Pupillary reaction was mildly sluggish in the affected eye of one of the patients. Fundus of first and third patient showed fresh vitreous hemorrhage and dense subfoveal haemorrhage while the second patient had white vitreous hemorrhage and large subfovealhemorrhage with altered blood. Post-injection all the three patients showed displacement of subfoveal hemorrhage within 2 weeks with improvement in best corrected visual acuity. No surgical complications or incidences of re-bleeding were observed during the follow-up period
Pneumatic displacement is an effective treatment for subfoveal haemorrhage due to recent and old blunt trauma. Displcement of haemorrhage achieved without the use of tissue plasminogen activator. Co-existing vitreous haemorrhage did not hinder the displacement. Second patient though presented late still displacement was achieved. Significant recovery of visual acuity can occur in patients provided good compliance is shown by the patient for prone positioning.