Managing Massive Subretinal Hemorrhage Without Surgery

Two patients with massive subretinal hemorrhage demonstrated sustained long-term stability following intravitreal anti-VEGF monotherapy.

By: Michael Y. Zhao, MD, Harry W. Flynn Jr., MD

Retinal Physician July 1, 2026 Vol 23, Issue July-August 2026 Page(s): 22-25

Clinical Report: Managing Massive Subretinal Hemorrhage Without Surgery

Background

Massive subretinal hemorrhage (mSRH) poses a significant challenge in ophthalmology, often resulting in poor visual prognosis. Commonly associated with neovascular age-related macular degeneration (nAMD) and other conditions, mSRH requires effective management strategies. Current treatment options include anti-VEGF injections, pars plana vitrectomy (PPV) with tissue plasminogen activator (tPA), and pneumatic displacement with gas tamponade, but a standardized approach remains elusive.

Data Highlights

No numerical data or trial data presented in the article, which limits the ability to draw broader conclusions about treatment efficacy.

Key Findings

Two patients with mSRH were treated with anti-VEGF monotherapy.
Both patients showed sustained long-term stability over follow-up periods of 10 and 20 years.
Case 1 involved a 71-year-old female with wet AMD, achieving BCVA of 20/200 after treatment.
Case 2 involved a 60-year-old female with PEHCR, achieving BCVA of 20/25 after treatment.
Both cases demonstrated resolution of hemorrhage and changes in retinal structure on OCT.

Clinical Implications

Long-term follow-up is essential to assess the stability of visual outcomes and retinal health.

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