Therapy of subhyaloidal haemorrhage by intravitreal application of rtPA and SF₆ gas

Editor,—Subhyaloidal haemorrhage in the premacular space may cause a sudden loss of central vision in eyes, where macular function was good before the incidence. It can be caused by different disorders such as vitreoretinal traction of different origins, trauma, Valsalva retinopathy, or occur spontaneously—for example, following partial detachment of the posterior hyaloid membrane. Different therapeutic approaches have been adopted for treatment of this situation. Spontaneous resorption of the haemorrhage can be awaited, which may be limited by the frequently slow course of resolution. Nd:YAG laser photodisruption of the posterior hyaloid membrane has been described to achieve distribution of the haemorrhage in the vitreous, which resulted in accelerated clearing and visual improvement.1 Pars plana vitrectomy can be performed for complete surgical separation of the posterior hyaloid membrane and removal of the whole haemorrhage.

We report on a case of acute premacular subhyaloidal haemorrhage, which was treated successfully by subsequent injection of recombinant tissue plasminogen activator (rtPA) and sulphur hexafluoride gas (SF₆).