Managing Massive Subretinal Hemorrhage Without Surgery - Report - MDSpire

Managing Massive Subretinal Hemorrhage Without Surgery

Two patients with massive subretinal hemorrhage demonstrated sustained long-term stability following intravitreal anti-VEGF monotherapy.

  • By

  • Michael Y. Zhao, MD

  • Harry W. Flynn Jr., MD

  • July 1, 2026

  • 11 min

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Clinical Report: Managing Massive Subretinal Hemorrhage Without Surgery

Background

Massive subretinal hemorrhage (mSRH) poses a significant challenge in ophthalmology, often resulting in poor visual prognosis. Commonly associated with neovascular age-related macular degeneration (nAMD) and other conditions, mSRH requires effective management strategies. Current treatment options include anti-VEGF injections, pars plana vitrectomy (PPV) with tissue plasminogen activator (tPA), and pneumatic displacement with gas tamponade, but a standardized approach remains elusive.

Data Highlights

No numerical data or trial data presented in the article, which limits the ability to draw broader conclusions about treatment efficacy.

Key Findings

  • Two patients with mSRH were treated with anti-VEGF monotherapy.
  • Both patients showed sustained long-term stability over follow-up periods of 10 and 20 years.
  • Case 1 involved a 71-year-old female with wet AMD, achieving BCVA of 20/200 after treatment.
  • Case 2 involved a 60-year-old female with PEHCR, achieving BCVA of 20/25 after treatment.
  • Both cases demonstrated resolution of hemorrhage and changes in retinal structure on OCT.

Clinical Implications

Long-term follow-up is essential to assess the stability of visual outcomes and retinal health.

Related Resources & Content

  1. Retinal Physician, March 2020 -- Autologous Retinal Patch Graft for Refractory Large Macular Holes
  2. Retinal Physician, October 2017 -- Management of Recurrent Vitreous Hemorrhage After Diabetic Vitrectomy
  3. New Retinal Physician, November/December 2021 -- Suprachoroidal Hemorrhages During Cataract Surgery
  4. Management of submacular hemorrhage: from a case report to a comprehensive review of current treatment strategies | International Ophthalmology | Springer Nature Link
  5. Age-Related Macular Degeneration Preferred Practice Pattern® - PubMed
  6. Retinal Physician — Proliferative Diabetic Retinopathy: A Brief Review of Medical and Surgical Management
  7. Management of submacular hemorrhage: from a case report to a comprehensive review of current treatment strategies | International Ophthalmology | Springer Nature Link
  8. Age-Related Macular Degeneration Preferred Practice Pattern® - PubMed
  9. Tissue Plasminogen Activator or Perfluoropropane for Submacular Hemorrhage in Age-Related Macular Degeneration: A Factorial Randomized Clinical Trial - PMC

Original Source(s)

Managing Massive Subretinal Hemorrhage Without Surgery

  • by Michael Y. Zhao, MD, Harry W. Flynn Jr., MD

  • July 1, 2026

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