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OPHTHALMIC IMAGE
Year : 2019  |  Volume : 67  |  Issue : 7  |  Page : 1185

Multimodal imaging of pre-macular subhyaloid hemorrhage managed with Nd:YAG laser hyaloidotomy


Department of Vitreo-Retina, Dr. Shroff's Charity Eye Hospital, New Delhi, India

Date of Web Publication25-Jun-2019

Correspondence Address:
Dr. Manisha Agarwal
Department of Vitreo-Retina, Dr. Shroff's Charity Eye Hospital, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijo.IJO_1863_18

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How to cite this article:
Agarwal M, Gupta C, Ranjan R, Kumar B, Shrivastav A, Kumar S. Multimodal imaging of pre-macular subhyaloid hemorrhage managed with Nd:YAG laser hyaloidotomy. Indian J Ophthalmol 2019;67:1185

How to cite this URL:
Agarwal M, Gupta C, Ranjan R, Kumar B, Shrivastav A, Kumar S. Multimodal imaging of pre-macular subhyaloid hemorrhage managed with Nd:YAG laser hyaloidotomy. Indian J Ophthalmol [serial online] 2019 [cited 2019 Jul 20];67:1185. Available from: http://www.ijo.in/text.asp?2019/67/7/1185/261028



A 40-year-old female presented with the complaints of sudden diminution of vision in the right eye for last 1 week. The best corrected visual acuity (BCVA) in the right eye was 3/60, N36. No abnormality was detected in the anterior segment. Intraocular pressure was recorded as 15 mmHg. Fundus of the right eye showed triangular-shaped premacular subhyaloid hemorrhage extending beyond the superior arcade with surrounding exudation at the temporal border of the hemorrhage [Figure 1]a.
Figure 1: (a) Fundus photo of the right eye showing premacular subhyaloid hemorrhage with laser opening and drainage of blood in the vitreous cavity. (b) Right eye fundus shows circular opening in the posterior hyaloid face at the laser hyaloidotomy. (c) OCT scan through the laser hyaloidotomy showing opening in the posterior hyaloid face. (d) Ultrasound B-scan showing opening in the posterior hyaloid face

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Nd:YAG laser hyaloidotomy was performed at the dependent part of the subhyaloid hemorrhage sparing the fovea, leading to slow diffusion of the subhyaloid hemorrhage into the vitreous cavity. Follow-up at 1 week, the BCVA in the right eye had improved to 6/9, N8 and fundus examination showed resolution of the subhyaloid hemorrhage with vitreous hemorrhage inferiorly. Follow-up at 3 weeks, the BCVA in the right eye was 6/6, N6 and fundus showed clear vitreous cavity with complete resolution of the subhyaloid hemorrhage and a circular ring was appreciated at the posterior pole [Figure 1]b.

Optical coherence tomography scan of the right eye passing through the circular ring showed an opening in the posterior hyaloid face [Figure 1]c. Ultrasound B-scan also showed an opening in the posterior hyaloid face [Figure 1]d. We report this case to highlight the role of Nd: YAG laser hyaloidotomy[1],[2],[3],[4] in the management of premacular subhyaloid hemorrhage leading to early visual recovery.

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understands that her name and initials will not be published and due efforts will be made to conceal her identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Khadka D, Bhandari S, Bajimaya S, Thapa R, Paudyal G, Pradhan E. Nd:YAG laser hyaloidotomy in the management of premacular subhyaloid hemorrhage. BMC Ophthalmol 2016;16:41.  Back to cited text no. 1
    
2.
Puthalath S, Chirayath A, Shermila MV, Sunil MS, Ramakrishnan R. Frequency-doubled Nd: YAG laser treatment for premacular hemorrhage. Ophthalmic Surg Lasers Imaging 2003;34:284-90.  Back to cited text no. 2
    
3.
Rennie CA, Newman DK, Snead MP, Flanagan DW. Nd: YAG laser treatment for premacular subhyaloid hemorrhage. Eye 2001;15:519-24.  Back to cited text no. 3
    
4.
Kwok-Cheung C, Moon-Kwong T, Raymond KK. Photodisruption of dense subhyaloid premacular hemorrhage with neodymium: YAG laser. HKJ Ophthalmol 2004;8:36-7.  Back to cited text no. 4
    


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