Fang Helen Mi » Sub Macular Hemorrhage secondary to Polypoidal Choroidal Vasculopathy

Jul 5 2021 by Fang Helen Mi

A 69-year-old gentleman with a history of atrial fibrillation on Factor Xa inhibitor (rivaroxaban) presented to the Ophthalmology service with acute blurring of vision in the right eye one day after intravitreal aflibercept injection. Fundus examination revealed a massive foveal-involving sub-macular hemorrhage with associated serosanguineous retinal detachment and hemorrhagic retinal pigment epithelial detachment. This multi-layer retinal hemorrhage was further confirmed with optical coherence tomography.

Imaging device: Clarus Camera

Condition/keywords: polypoidal choroidal vasculopathy (PCV), Rivaroxaban, submacular hemorrhage

Jul 5 2021 by Fang Helen Mi

The patient underwent urgent intravitreal injection of recombinant tissue plasminogen activator and pneumatic displacement with 100% C3F8 gas. The following day, the sub-macular haemorrhage was largely displaced away from the fovea inferiorly and nasally, with the gas bubble seen superiorly.

Imaging device: Clarus Camera

Condition/keywords: gas pneumatic displacement, polypoidal choroidal vasculopathy (PCV), submacular hemorrhage

Jul 5 2021 by Fang Helen Mi

Indocyanine green angiography revealed three polypoidal choroidal vasculopathy lesions, and the patient underwent photodynamic therapy the following week. His vision improved to 20/30.

Condition/keywords: indocyanine green (ICG) angiography, polypoidal choroidal vasculopathy (PCV), submacular hemorrhage