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Fırat Ü.Tıp Fakül.Göz Hast.ABD., Elazığ Purpose: Premacular subhyaloid hemorrhage is usually a benign condition that generally improves spontaneously and rarely causes visual loss. However, because premacular hemorrhage may be associated with permanent macular changes before it spontaneously resolves, Nd: YAG laser posterior hyaloidotomy may be indicated in selected cases. This study was undertaken to assess an alternative, Nd: YAG laser treatment, in treating this type of hemorrhage.
Material-Metod: This study was performed between 1996 and 1999. Six patients had a circumscribed premacular hemorrhage in one eye and who were treated with the Nd: YAG laser to drain the entrapped blood into the vitreous cavity. The size of the hemorrhage expressed in disc diameters.
Results: The mean size of the pretreatment hemorrhage was 5.7 (3.5-8.0) disc diameters. The visual acuities of all cases before laser treatment was at the level of hand motions. In all eyes, following Nd:YAG laser treatment, the hemorrhage instantaneously was drained into the vitreous cavity, resulting in a rapid improvement of vision. Complete drainage of the premacular hemorrhage was occured in within one week. Visual acuity improved dramatically within one week. The mean period of follow-up was 26.3 (7-42) months. No retinal damage or rebleeding occured due to the laser treatment, any vitrectomy was not required in any eye.
Conclusion: Nd:YAG laser posterior hyaloidotomy may be useful in drainage of premacular hemorrhage into the vitreous cavity in selected cases. To establish this treatment as a routine procedure, a randomized trial is needed to evaluate observation, primary vitrectomy, and NdrYAC laser treatment of premacular hemorrhage. Keywords : Nd:YAG laser, premacular subhyaloid hemorrhage, subinternal limiting membrane hemorrhage Nd:YAG laser posterior hyaloidotomy