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Clinical Ophthalmology
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Intravitreal ranibizumab in treating extensive traumatic submacular hemorrhage
Case report
(2157) Total Article Views
Authors: Abdul-Salim I, Embong Z, ST Khairy-Shamel, Raja-Azmi MN
Published Date April 2013 Volume 2013:7 Pages 703 - 706
DOI: http://dx.doi.org/10.2147/OPTH.S42208
Received: | 31 December 2012 |
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Accepted: | 29 January 2013 |
Published: | 09 April 2013 |
1Department of Ophthalmology, School of Medical Sciences, Universiti Sains Malaysia; 2Universiti Sains Malaysia Hospital, Jalan Raja Perempuan Zainab II, Kubang Kerian, Malaysia
Abstract: Herein, we report our experience in treating extensive traumatic submacular hemorrhage with a single dose of intravitreal ranibizumab. A 23-year-old healthy Malay man presented with a progressive reduction of central vision in the left eye of 2 days’ duration following a history of blunt trauma. Visual acuity was reduced to counting fingers. Examination revealed infero-temporal subconjunctival hemorrhage, traumatic anterior uveitis, and an extensive submacular hemorrhage with suspicion of a choroidal rupture in the affected eye. He was initially treated conservatively with topical prednisolone acetate 1%. The subconjunctival hemorrhage and anterior uveitis resolved but his vision remained poor with minimal resolution of the submacular hemorrhage at 1 week follow-up (day 12 post-trauma). In view of the poor resolution of submacular hemorrhage, he was treated with a single dose of 0.5 mg intravitreal ranibizumab at day 20 post-trauma. At 4 weeks post-intravitreal ranibizumab, there was an improvement in visual acuity (from counting fingers to 6/45) and complete resolution of the submacular hemorrhage with presence of a choroidal rupture scar temporal to the fovea, which was not seen clearly at presentation due to obscuration by blood. His visual acuity further improved to 6/18 at 3 months post-trauma. Although this single case had a favorable outcome, a large population cohort study is needed to establish the effectiveness of intravitreal ranibizumab in treating extensive traumatic submacular hemorrhage.
Keywords: trauma, choroidal rupture scar, visual acuity, submacular hemorrhage, anterior uveitis
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