Clinical profile and management outcomes of traumatic submacular hemorrhage

Purpose: to evaluate the anatomical and functional outcome of patients with traumatic submacular hemorrhage (smh). methods: a retrospective, interventional case series of patients presenting between january 2016 and april 2018 was carried out at 4 tertiary eye care centers of india. medical records of the patients with a history of blunt trauma and smh were retrospectively reviewed. the intervention done was any one of the following: pneumatic displacement with 0.3 ml of intravitreal gas [100% perfluoropropane (c3f8) gas], pneumatic displacement with intravitreal 0.3 ml of 100% c3f8 gas combined with 100 mg/0.1 ml of recombinant tissue plasminogen activator (r-tpa), pars plana vitrectomy (ppv) with subretinal r-tpa and gas tamponade. the primary outcome measures included change in visual and anatomical status. results: twenty eyes of 20 patients with blunt trauma were analyzed. thirteen patients had small size smh, 5 patients had medium size smh, and 2 patients had massive size smh. sixteen patients had a favorable functional outcome, and eighteen patients had favorable anatomical outcome. the size and duration of post-traumatic smh did not significantly affect the anatomical (p ¼ 0.123) or functional (p ¼ 0.293) outcome in our study. the patients who presented with initial visual acuity of 6/60 or better showed better functional outcome, which was statistically significant (p ¼ 0.007). conclusion: minimally non-invasive procedure including intravitreal r-tpa and gas appear to be effective in the displacement of post-traumatic smh.