Pneumatic displacement of submacular hemorrhage: safety, efficacy, and patient selection

Retina. 2007 Mar;27(3):329-34. doi: 10.1097/01.iae.0000231544.43093.40.


Purpose: To investigate the safety and efficacy of pneumatic displacement of submacular hemorrhage without the use of intravitreal tissue plasminogen activator (tPA).

Methods: In a prospective, consecutive, single-center, noncomparative, interventional case series, 20 consecutive patients with submacular hemorrhage due to various etiologies (duration, 1-30 days; visual acuity, hand movements to 20/125) were treated with intravitreal perfluoropropane gas injection followed by prone positioning for 5 days to 7 days. Patients were observed 1 day, 7 days, 30 days, 3 months, 6 months, and 1 year after the procedure.

Results: Submacular blood was completely or partially displaced from the fovea in 16 of 20 eyes within 7 days after the injection. Mean best-corrected visual acuity improved from 1.6 to 0.72 logarithm of minimum angle of resolution, which was statistically significant (Wilcoxon signed rank test, P = 0.001). Final visual acuity was 20/63 or better in 10 eyes (50%). The change in proportion of eyes with best-corrected visual acuity of 20/63 or better after treatment was statistically significant (McNemar test, P = 0.002). Four patients developed nonresolving vitreous hemorrhage, which necessitated vitrectomy.

Conclusion: The results of pneumatic displacement of submacular hemorrhage using perfluoropropane gas are encouraging, thus questioning the role of tPA in the management of such cases.

MeSH terms

  • Adult
  • Aged
  • Female
  • Fluorocarbons / adverse effects
  • Fluorocarbons / therapeutic use*
  • Humans
  • Injections
  • Male
  • Middle Aged
  • Patient Selection
  • Pressure*
  • Prone Position*
  • Prospective Studies
  • Retinal Hemorrhage / therapy*
  • Treatment Outcome
  • Visual Acuity
  • Vitreous Body


  • Fluorocarbons
  • perflutren