Pneumatic displacement of subretinal hemorrhage without tissue plasminogen activator

Arch Ophthalmol. 1998 Oct;116(10):1326-32. doi: 10.1001/archopht.116.10.1326.


Objective: To assess the efficacy and complications of intravitreal injection of perfluoropropane gas for displacement of subretinal hemorrhage (SRH), without the use of tissue plasminogen activator.

Patients and methods: Pure perfluoropropane gas (0.4-0.5 mL) was injected into the vitreous cavity in 5 patients with SRH involving the fovea because of age-related macular degeneration (4 eyes) or ruptured retinal arterial macroaneurysm (1 eye). The patients were instructed to maintain a prone position.

Results: Visual acuity ranged from 20/300 to 20/2000 before gas injection. On the day after gas injection, SRH was dramatically displaced in 3 eyes and slightly displaced with a reduction in the thickness of subfoveal hemorrhage in the remaining 2 eyes. Final visual acuity improved in all cases, ranging from 20/15 to 20/220. Three eyes had a final visual acuity of 20/50 or better. Vitreous hemorrhage caused by migration of SRH into the vitreous cavity and retinal detachment each occurred in 1 eye, and both complications were successfully treated by vitrectomy.

Conclusions: Gas injected into the vitreous cavity can displace SRH without the use of tissue plasminogen activator in some cases. Visual acuity after gas injection may be improved, making this treatment an alternative to evacuation of SRH with vitrectomy.

Publication types

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

MeSH terms

  • Aged
  • Aneurysm, Ruptured / complications
  • Aneurysm, Ruptured / pathology
  • Female
  • Fluorocarbons / administration & dosage*
  • Fundus Oculi
  • Humans
  • Macular Degeneration / complications
  • Male
  • Middle Aged
  • Prone Position
  • Retinal Artery / pathology
  • Retinal Detachment / etiology
  • Retinal Detachment / surgery
  • Retinal Hemorrhage / etiology
  • Retinal Hemorrhage / therapy*
  • Tissue Plasminogen Activator*
  • Visual Acuity
  • Vitrectomy
  • Vitreous Body
  • Vitreous Hemorrhage / etiology
  • Vitreous Hemorrhage / surgery


  • Fluorocarbons
  • perflutren
  • Tissue Plasminogen Activator