Clinical Scorecard: Robotic-Assisted Subretinal Injection Over an Ultra-Long Distance for Submacular Hemorrhage
At a Glance
Category
Detail
Condition
Submacular hemorrhage (SMH) is linked to neovascular age-related macular degeneration, polypoidal choroidal vasculopathy, and retinal arterial macroaneurysm.
Key Mechanisms
Blood products can exert mechanical and biochemical toxicity on photoreceptors and the retinal pigment epithelium, potentially causing irreversible retinal damage.
Target Population
The report describes one 42-year-old man with fovea-centered SMH in the right eye; the supplied excerpt does not state the underlying cause.
Care Setting
A single-case report of remote robotic subretinal rt-PA injection between sites approximately 4000 km apart, with local pars plana vitrectomy and fluid-air exchange.
Key Highlights
Remote robotic-assisted subretinal rt-PA injection was completed without conversion to manual surgery or intraoperative complications.
The procedure used 0.056 mL of rt-PA at 0.5 mg/mL; total surgery time was 46 minutes.
The supplied excerpt reports serial imaging and near-complete hemorrhage absorption at postoperative day 30; it does not establish complete resolution by day 23.
The supplied excerpt does not provide the stated 3-month adverse-event or BCVA outcomes.
Guideline-Based Recommendations
Diagnosis
Fundus photography and OCT were used to identify and follow SMH; OCT documented hemorrhage dimensions and associated pigment epithelial detachment.
The supplied excerpt does not report indocyanine green angiography or establish polypoidal choroidal vasculopathy as the cause in this patient.
Management
The reported procedure combined local pars plana vitrectomy with remote robotic subretinal rt-PA administration, followed by fluid-air exchange.
Preoperative OCT guided the planned injection site and depth; injection was stopped when the intended bleb formed.
The supplied excerpt does not report conbercept treatment.
Monitoring & Follow-up
The report assessed adverse events, procedural completion, BCVA, and OCT-based hemorrhage resolution.
The excerpt describes ultra-widefield fundus photography and serial OCT; additional imaging was permitted when clinically indicated.
Risks
The article states that SMH can cause potentially irreversible retinal damage through mechanical and biochemical toxicity to photoreceptors and the retinal pigment epithelium.
The supplied excerpt reports no intraoperative complications; it does not provide the stated 3-month serious-adverse-event outcome.
Patient & Prescribing Data
One 42-year-old man with sudden central scotoma and right-eye vision loss beginning 2 weeks before treatment; preoperative right-eye BCVA was 0.6 logMAR (20/80).
Under general anesthesia, the patient underwent local 25-gauge pars plana vitrectomy followed by remote robotic subretinal injection of 0.056 mL rt-PA at 0.5 mg/mL. This single case does not establish general treatment effectiveness.
Clinical Best Practices
In the reported procedure, preoperative OCT guided the planned subretinal injection site and depth.
In the reported robotic workflow, low-flow infusion was used and delivery stopped when the intended bleb formed.
The report assessed hemorrhage resolution with serial imaging and monitored visual acuity and adverse events.
by Andi Xu, Bo Yang, Bingqian Liu, Lin Lu, Zhangkai Lian, Wenben Chen, Rihui Song, Wang Guo, Subinuer Alimu, Zhenzhen Liu, Dong Liu, Yanlin Li, Wei Xiao, Mohammad Ali Nasseri, Kai Huang, Haotian Lin
