Abstract

SA.09.04

Diagnostic tools to differentiate subhyaloidal and macular hemorrhage

Mennel S.¹, Meyer C. H.², Callizo J.¹, Schmidt J. C.¹, Kroll P.^1
1Department of Ophthalmology, Philipps-University Marburg; ²Department of Ophthalmology, University of Bonn

Objective: Differentiating subhyaloidal and sub- internal limiting membrane (ILM) hemorrhage is a controversial issue. Histologic analysis following vitrectomy has showed in many cases a sub-ILM location of the hemorrhage. It seems questionable whether diagnostic tools allow a reliable preoperative location of the cleavage plane.
Methods: Three patients with presumed subhyaloidal hemorrhage were examined by funduscopy, ultrasound and optical coherence tomography (OCT). One case underwent vitrectomy and in the other cases laser membranotomy was perfomed. Additionally, literature research was perfomed to find diagnostic tools to differentiate subhyaloidal and sub-ILM hemorrhage.
Results: In any of our cases we could not find definitive clinical signs to differentiate the cleavage plane. Intraoperative evaluation and postoperative OCT allowed to classify the hemorrhage as sub-ILM hemorrhage.
Conclusions: Only in selected cases funduscopy, ultrasound and OCT allows to elucidate the location of the hemorrhage. These examinations seems to be more reliable if the posterior hyaloid is already detached. After performing surgical intervention the OCT presents as an appropriate method to differentiate subhyaloid and sub-ILM hemorrhage.

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