Management of submacular hemorrhage associated with retinal arterial macroaneurysms

Michael Humayun, Hilel Lewis, Harry W. Flynn, Paul Sternberg, Mark S. Blumenkranz

Research output: Contribution to journalArticlepeer-review

61 Scopus citations


PURPOSE: Experience is reported with intraoperative pharmacologic lysis of recent submacular hemorrhage with tissue plasminogen activator followed by surgical drainage of the unclotted blood in patients with retinal arterial macroaneurysms. METHODS: Nine eyes (nine patients) with a recent (≤7 days old) submacular hemorrhage involving the center of the fovea secondary to retinal arterial macroaneurysm that were managed with recombinant tissue plasminogen activator-assisted subretinal hemorrhage evacuation, including subretinal injection of tissue plasminogen activator and removal of the liquefied blood. Patients were followed for a mean 18 ± 7 months (range, 7 to 30 months). RESULTS: All nine eyes had improved final corrected visual acuity after surgery, and eight eyes (89%) attained a corrected visual acuity of 20/60 or better (mean, 20/40; range, 20/20 to 20/200). Final corrected visual acuity was limited to 20/200 in one eye. Two eyes developed a cataract that required surgery. CONCLUSIONS: Submacular surgery with tissue plasminogen activator-assisted thrombolysis achieved improved best-corrected visual acuity in eyes with recent submacular hemorrhage involving the center of the fovea associated with retinal arterial macroaneurysm.

Original languageEnglish (US)
Pages (from-to)358-361
Number of pages4
JournalAmerican journal of ophthalmology
Issue number3
StatePublished - Sep 1 1998

ASJC Scopus subject areas

  • Ophthalmology


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