We report the case of an 80-year-old male who came to the emergency department with a 2-day history of decreased visual acuity (VA) of the right eye (OD).
His medical history included hypertension and dyslipidemia under treatment, chronic bronchitis and transient ischemic attack requiring antiplatelet therapy with aspirin.
The exploration in emergency is the next one.
VA due to OD: light perception (PL); left eye (LE): 1; afferent pupil defect of OD 3+/4+; intraocular pressure OD: 16; macular fundus omicr: 17;
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A fluorescein angiography (FAG) was performed to confirm the subretinal location of this hemorrhage, along with a juxtafoveolar inferior hyperfluorescent area (NVM) indicating the presence of a neovascular membrane.
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Two days later, 25 μg of r-TPA are injected intravitreally in a volume of 0.1 ml, followed by an injection of 0.3 ml of 0.2 ml of pure evacuating hexafluoride (SF6) and one for 0.4 ml.
After 3 days, the patient is seen to have blood partially displaced from the posterior pole, along with fibrin zones.
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One month after this procedure, the patient came back for review with an VA of 0.05 and funduscopy showed a decrease in bleeding, with blood remaining in the macular and fibrin areas in the lower zone.
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One month later, the patient came for review and funduscopy showed a subretinal hemorrhage of extension similar to that presented at diagnosis, so she was diagnosed with intravitreal AMD with rantreib doses.
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After the ranibizumab cycle, the patient visited the hospital and had a VA by the RE of LP and the LE of 1.
Funduscopy showed the presence of a hemovitreous that prevented adequate visualization of the structures of the posterior pole.
Currently, it is still under study to assess the following therapeutic step.
