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Fujikawa, Masato MD*; Sawada, Osamu MD*; Miyake, Taichiro MD*; Kakinoki, Masashi MD*; Sawada, Tomoko MD*; Kawamura, Hajime MD*; Sakaguchi, Hirokazu MD; Gomi, Fumi MD; Ohji, Masahito MD*

doi: 10.1097/IAE.0b013e318287d99d
Original Study

Purpose: To retrospectively evaluate efficacy, safety, and visual outcomes of pneumatic displacement for submacular hemorrhages (SMHs) with or without tissue plasminogen activator (tPA).

Methods: Sixty-eight eyes with fresh SMHs underwent pneumatic displacement. Thirty eyes received intravitreal injection of pure C3F8 gas alone and 38 eyes received gas with tPA (25 μg). The visual analog scale was used to evaluate displacement. The main outcome measures were the visual analog scale score and best-corrected visual acuity 1 month after treatment. The efficacy and safety of tPA were evaluated.

Results: The visual analog scale score was 4.9 ± 2.5 in the gas group and 5.9 ± 2.9 in the gas plus tPA group. Sixteen eyes (53.3%) in the gas group and 15 eyes (39.5%) in the gas plus tPA group had best-corrected visual acuity improvements. In the gas group, complications included retinal detachment (n = 1, 3.3%), vitreous opacity (n = 7, 23.3%), and rebleeding (n = 1, 3.3%). In the gas plus tPA group, vitreous opacity (n = 6, 15.8%) was the only complication. Overall, both groups had similar displacement of SMH, visual improvement, and complication rates at 1 month.

Conclusion: Intravitreal injection of pure C3F8 gas displaced SMHs and improved best-corrected visual acuity in eyes with SMHs. No adjuvant effect or adverse reactions of tPA were found.

Supplemental Digital Content is Available in the Text.Pneumatic displacement of submacular hemorrhage with or without tissue plasminogen activator is an effective and safe procedure.

*Department of Ophthalmology, Shiga University of Medical Science, Otsu, Japan; and

Department of Ophthalmology, Osaka University, Suita, Japan.

Reprint requests: Masato Fujikawa, MD, Department of Ophthalmology, Shiga University of Medical Science, Seta Tsukinowacho, Otsu, Shiga, 520-2192, Japan; e-mail:

Supported in part by a grant from the Ministry of Education, Culture, Sports, Science and Technology of Japan (#18591915) and a grant from the Ministry of Health, Labor, and Welfare.

The authors declare no conflict of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

© 2013 by Ophthalmic Communications Society, Inc.