Balughatta Poornachandra, Kadri Venkatesh, Braganza Sherine, Jayadev Chaitra, Mehta Ruchir A, Nakhate Vikram, Yadav Naresh K, Shetty Rohit
Department of Retina, Narayana Nethralaya Eye Hospital, Bengaluru, India.
Retin Cases Brief Rep. 2019;13(1):34-38. doi: 10.1097/ICB.0000000000000525.
To evaluate the efficacy of intravitreal gas (perfluoropropane, C3F8)-assisted displacement of submacular hemorrhage (SMH) secondary to recent or old blunt trauma.
An interventional case series of three patients who presented with SMH after blunt trauma, ranging from 2 days to 2 weeks back. All three patients were treated with an intravitreal injection of 0.3 cc of 100% C3F8 with anterior chamber paracentesis. Strict prone position was advised for 2 weeks with a minimum of 6 to 8 hours per day. Documentation was done with serial recording of corrected distance visual acuity, fundus photographs, and spectral domain optical coherence tomography both before and after intervention.
The follow-up period ranged from 2 weeks to 3 months. All patients showed a significant displacement of SMH with recovery of the normal foveal contour; foveal thinning was noted in 2 cases. Best spectacle-corrected visual acuity improved from counting finger at 1 m to 20/30 in Case 1 and counting finger 3 m to 20/40 in Case 2. In Case 3, the visual acuity remained unchanged from the preoperative 20/60 which could be attributed to the presence of a choroidal rupture in the foveal area that became evident after the displacement of SMH.
Pneumatic displacement is an effective technique in the management of SMH due to recent or old blunt trauma.
评估玻璃体内气体（全氟丙烷，C3F8）辅助移位治疗近期或陈旧性钝挫伤继发的黄斑下出血（SMH）的疗效。
一项介入性病例系列研究，纳入3例钝挫伤后出现SMH的患者，受伤时间为2天至2周。所有3例患者均接受了0.3 cc 100% C3F8的玻璃体内注射及前房穿刺。建议严格俯卧位2周，每天至少6至8小时。干预前后均通过连续记录矫正远视力、眼底照片和光谱域光学相干断层扫描进行记录。
随访期为2周至3个月。所有患者的SMH均有明显移位，中央凹轮廓恢复正常；2例患者出现中央凹变薄。最佳矫正视力方面，病例1从1米处数指提高到20/30，病例2从3米处数指提高到20/40。病例3的视力与术前20/60相比无变化，这可能归因于中央凹区域存在脉络膜破裂，在SMH移位后变得明显。
气体移位术是治疗近期或陈旧性钝挫伤所致SMH的有效技术。
