Title: Macular Rescue in PCV: Day-One Anatomical Triumph
Description: A 66-year-old male presented with sudden diminution of vision in the left eye for 2 weeks. Best corrected visual acuity was counting fingers at 1 meter. Fundus evaluation revealed a dense submacular hemorrhage, and OCT demonstrated a large pigment epithelial detachment (PED) with heterogeneous hyperreflective submacular material. The diagnosis was submacular hemorrhage secondary to Polypoidal Choroidal Vasculopathy (PCV)
The patient underwent intravitreal alteplase (50 µg) followed by 0.3 cc C3F8 gas injection for pneumatic displacement. On postoperative day 1, visual acuity improved to 6/36. Fundus examination showed inferotemporal displacement of the submacular hemorrhage away from the fovea. OCT confirmed significant reduction of subfoveal blood with persistent PED
This case highlights the effectiveness of timely thrombolysis with pneumatic displacement in restoring foveal anatomy and achieving rapid visual improvement in PCV-related massive submacular hemorrhage
