OBJECTIVE: To evaluate the safety and efficacy of pars plana vitrectomy to treat massive macular hemorrhage caused by retinal arterial macroaneurysm. DESIGN: Retrospective case series. PARTICIPANTS: Eight eyes of eight patients. METHODS: We retrospectively reviewed the charts for eight eyes of eight patients in which pars plana vitrectomy had been performed to remove a massive macular hemorrhage secondary to a ruptured retinal arterial macroaneurysm. In each case, the preretinal/intralamellar hemorrhage was removed, and in three of the eight eyes a subretinal hemorrhage was removed via a retinotomy after clot lysis using tissue plasminogen activator. MAIN OUTCOME MEASURE: Pars plana vitrectomy to treat macular hemorrhage secondary to retinal arterial macroaneurysm. RESULTS: The duration of symptoms ranged from 10 to 80 days (average, 31 days). The preoperative visual acuities ranged from counting fingers to 0.09. Follow-up ranged from 3 to 36 months (average, 19 months). The postoperative visual acuities improved in seven eyes and remained unchanged in one; vision was better than 0.1 in six eyes and better than 0.4 in five. Postoperative complications included a mild vitreous hemorrhage in two eyes, a macular hole in one, and a cataract in two. CONCLUSIONS: Pars plana vitrectomy appears to be relatively safe and effective in treating massive macular hemorrhage caused by a retinal arterial macroaneurysm.
OBJECTIVE: To evaluate the safety and efficacy of pars plana vitrectomy to treat massive macular hemorrhage caused by retinal arterial macroaneurysm. DESIGN: Retrospective case series. PARTICIPANTS: Eight eyes of eight patients. METHODS: We retrospectively reviewed the charts for eight eyes of eight patients in which pars plana vitrectomy had been performed to remove a massive macular hemorrhage secondary to a ruptured retinal arterial macroaneurysm. In each case, the preretinal/intralamellar hemorrhage was removed, and in three of the eight eyes a subretinal hemorrhage was removed via a retinotomy after clot lysis using tissue plasminogen activator. MAIN OUTCOME MEASURE: Pars plana vitrectomy to treat macular hemorrhage secondary to retinal arterial macroaneurysm. RESULTS: The duration of symptoms ranged from 10 to 80 days (average, 31 days). The preoperative visual acuities ranged from counting fingers to 0.09. Follow-up ranged from 3 to 36 months (average, 19 months). The postoperative visual acuities improved in seven eyes and remained unchanged in one; vision was better than 0.1 in six eyes and better than 0.4 in five. Postoperative complications included a mild vitreous hemorrhage in two eyes, a macular hole in one, and a cataract in two. CONCLUSIONS: Pars plana vitrectomy appears to be relatively safe and effective in treating massive macular hemorrhage caused by a retinal arterial macroaneurysm.