Pathophysiology and management of subretinal hemorrhage

Michael A. Hochman, Christopher M. Seery, Marco A. Zarbin

Research output: Contribution to journalReview articlepeer-review

121 Scopus citations

Abstract

Subretinal hemorrhage can arise from the retinal and/or choroidal circulation. Significant subretinal hemorrhage occurs in several conditions, but most commonly is associated with age-related macular degeneration, presumed ocular histoplasmosis, high myopia, retinal arterial macroaneurysm, and trauma. Released toxins, outer retinal shear forces, and a diffusion barrier created by subretinal hemorrhage all contribute to photoreceptor damage and visual loss. The use of tissue plasminogen activator and improvements in surgical instrumentation have facilitated surgical drainage and have made it a useful option in the management of selected cases. Mechanisms of subretinal hemorrhage formation, underlying etiologies, diagnostic evaluation, and the histopathology of damage are summarized. Published surgical series are reviewed and surgical advances are summarized. The value of surgically removing subretinal hemorrhages to improve visual outcome remains unestablished, because definitive studies have not been performed. Guidelines for selecting candidates for surgical intervention are proposed.

Original languageEnglish (US)
Pages (from-to)195-213
Number of pages19
JournalSurvey of ophthalmology
Volume42
Issue number3
DOIs
StatePublished - Nov 1997

All Science Journal Classification (ASJC) codes

  • Ophthalmology

Keywords

  • Age-related macular degeneration
  • Choroidal neovascularization
  • Retinal arterial macroaneurysm
  • Retinal surgery
  • Subretinal hemorrhage
  • Tissue plasminogen activator

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