Intravitreal Expansile Gas and Bevacizumab Injection for Submacular Hemorrhage Due to Neovascular Age-related Macular Degeneration

Purpose: to evaluate the results of intravitreal expansile gas injection, with orwithout recombinant tissue plasminogen activator (rtpa), followed by intravitrealbevacizumab injection for treatment of submacular hemorrhage (smh) secondaryto neovascular age-related macular degeneration (amd).methods: in this interventional case series, 5 eyes of 5 patients with smh secondaryto choroidal neovascularization (cnv) due to neovascular amd were treated with 0.3cc intravitreal sf6 (and 50 ìg of rtpa in two eyes), followed by face-down positioning;24 hours later, 1.25 mg of bevacizumab was injected intravitreally. main outcomemeasures included displacement of smh and best corrected visual acuity (bcva).results: mean patient age was 75.6±9.2 (range, 60-83) years, mean duration of symptomswas 6.4±3.2 (range, 3-10) days, and mean number of bevacizumab injections was1.8 (range, 1-3). mean preoperative bcva was 1.28±0.27 logmar which improvedsignificantly to 0.57±0.33 logmar at 12 months (p=0.042). smh displacement occurredin all eyes, and visual acuity improved and remained stable during the follow-upperiod of 12 months.conclusion: intravitreal expansile gas injection, with or without rtpa, followedby intravitreal bevacizumab injection, seems to be an effective modality for smhdisplacement and treatment of the underlying cnv in neovascular amd