Successful management of a massive subretinal hemorrhage with intravitreal t-PA, perfluoropropane, and bevacizumab: a case report

Massive subretinal hemorrhage is a rare but vision-threatening complication of proliferative diabetic retinopathy. Rapid and effective intervention is essential to preserve visual function. We report the case of a 40-year-old woman with type 2 diabetes who presented with a sudden, severe bilateral visual acuity drop. Fundoscopy revealed a massive subretinal hemorrhage in the left eye. She was treated with intravitreal injections of tissue plasminogen activator (t-PA), perfluoropropane (C3F8), and bevacizumab. Post-treatment, the hemorrhage resolved with significant visual improvement. Minimally invasive treatment with t-PA, gas tamponade, and anti-VEGF agents is effective in managing massive subretinal hemorrhage and improving visual outcomes.