Treatment for submacular hemorrhage associated with neovascular age-related macular degeneration

Semin Ophthalmol. 2011 Nov;26(6):361-71. doi: 10.3109/08820538.2011.585368.


Submacular hemorrhage associated with neovascular age-related macular degeneration is a complication known to have potentially devastating effects on visual acuity. Multiple treatment modalities have been suggested including intravitreal anti-vascular endothelial growth factor injections, photodynamic therapy, pneumatic displacement with or without adjuvant intravitreal tissue plasminogen activator, and pars plana vitrectomy with or without adjuvant subretinal tissue plasminogen activator. However, there remains no consensus on optimal treatment, as clinical trials for neovascular age-related macular degeneration have excluded patients with submacular hemorrhage. This manuscript offers guidelines to the management of subretinal hemorrhage based on its size and characteristics, and highlights the need for clinical trials in this area.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Humans
  • Photochemotherapy
  • Pressure
  • Retinal Hemorrhage / etiology
  • Retinal Hemorrhage / therapy*
  • Tissue Plasminogen Activator / therapeutic use
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Visual Acuity
  • Vitrectomy
  • Wet Macular Degeneration / complications*


  • Angiogenesis Inhibitors
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Tissue Plasminogen Activator