Nd:YAG-laser membranotomy for long-term premacular hemorrhage (case report)

Premacular hemorrhages are accompanied by a sudden significant vision loss and may originate from by various causes, the most common of which are proliferative retinopathy associated with diabetic eye diseases, ischemic retinal vein occlusion, macroaneurysms, and Valsalva retinopathy. Small hemorrhages (less than 3 disc diameters) often resolve spontaneously, whereas large hemorrhages under the internal limiting membrane have a significantly reduced probability of spontaneous regression and increased risks of complications associated with the toxic effects of hemoglobin breakdown products. The main treatment method in these cases is Nd:YAG-laser membranotomy or hyaloidotomy. It allows effective and safe drainage of blood into the vitreous humor, where it is completely resorbed. The article presents a clinical case of a long-term premacular hemorrhage associated with retinal arterial macroaneurysm. Though Nd:YAG-laser membranotomy was performed late, it not only significantly improved visual functions, but also prevented invasive vitreal procedures. Three-year follow-up revealed no treatment complications.