FP360 : Treatment of subinternal limiting membrane hemorrhage with expansile octafluoropropane gas injection

Dr.DHAIVAT SHAH, S19586

Sub-internal limiting membrane (sub-ILM) hemorrhage is a relatively uncommon finding which is associated with different etiologies namely trauma, coughing and blood disorders. If it is involving the fovea, it may lead to profound visual loss due to de-hemoglobinization of heme. Various treatment protocols have been reported, like vitrectomy and ILM puncture, tPA hemolysis and pneumoretinopexy. We report a case of a 26 year old male, a known case of allergic bronchitis, who presented to us with complains of diminished vision in right eye since two months. There was an area of large sub-ILM bleed involving the fovea, confirmed on SD-OCT, which was treated with intravitreal injection of expansile octafluoropropane (100% C3F8) gas and prone positioning. At 2 weeks follow up, macular hemorrhage was totally resolved with complete visual recovery. We conclude that 100% C3F8 pneumoretinopexy is an effective and safe method for treating acute onset sub-ILM hemorrhage involving macula.