| The Recurrent Submacular Hemorrhage after Removal of Sub-Internal Limiting Membrane Hemorrhage with Retinal Arterial Macroaneurysm. |
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Jung Yeul Kim, Dong Won Heo, Young Joon Jo |
1Department of Ophthalmology, Chungnam National University College of Medicine, Daejeon, Korea. youngjoon@cnu.ac.kr
2Institute for Medical Sciences, Chungnam National University Research, Daejeon, Korea. |
| 망막대동맥류에 동반된 내경계막하출혈의 수술적 제거 후 발생한 황반하 재출혈 |
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김정열1,2⋅허동원1⋅조영준1,2 |
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Department of Ophthalmology, Chungnam National University College of Medicine1, Daejeon, Korea Institute for Medical Sciences, Chungnam National University Research2, Daejeon, Korea |
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Correspondence:
Young Joon Jo, MD |
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| Abstract |
PURPOSE
To report a case of a recurrent macular hemorrhage that developed after surgical removal of the internal limiting membrane (ILM) for subintimal hemorrhage due to retinal macroaneurysm. CASE SUMMARY: A 75-year-old female was admitted to the hospital complaining of decreased vision in the left eye which had started 3 weeks previously. The best corrected visual acuity (BCVA) of the right and left eye was 0.7 and 0.03, respectively. The intraocular pressure (IOP) of the right and left eye was 10 mm Hg and 12 mm Hg, respectively. On the fundus examination, macular preretinal and subretinal hemorrhage was observed and a diagnosis of retinal arterial macroaneurym of the inferonasal major artery was made. Vitrectomy was performed. After indocyanine green dye staining, the sub-ILM hemorrhage was treated with removal of the ILM. At postoperative day 3, the annular chorioretinal folds were observed due to the hypotony (4 mm Hg). However, the absence of leakage was confirmed through the sclerotomy site. At postoperative day 8, recurrent submacular hemorrhage occurred and the hemorrhage was observed to have spread after intravitreal C3F8 gas injection and when the patient was placed in the prone position. At postoperative 4 months, the hemorrhage that had invaded the macular area was completely resolved. The BCVA was 0.3, respectively. CONCLUSIONS: When removing a sub-ILM hemorrhage due to retinal macroaneurysm, recurrent hemorrhage can occur especially in a patient with ocular hypotony, as in the present case report. Physicians should be aware of this possibility and the proper treatment the condition requires. |
| Key Words:
Hypotony;Indocyanine green dye staining;Recurrent submacular hemorrhage;Retinal arterial macroaneurysm;Sub-Internal limiting membrane hemorrhage |
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