Title: A series of unfortunate events
Description: A 56-year-old male with uncontrolled hypertension presented with sudden reduction of vision in his left eye. Clinical examination revealed hypertensive retinopathy in both eyes, with a subretinal hemorrhage in the left eye. He was treated with an intravitreal injection of tissue plasminogen activator (tPA) combined with C3F8 gas injection in the left eye, followed by prone positioning to facilitate clot displacement. 2 weeks post-procedure, the patient developed a breakthrough vitreous hemorrhage in the same eye. At three weeks, the expanding gas bubble caused a retinal break, leading to subtotal retinal detachment. This case underscores the critical importance of thorough pre-procedure counseling. Patients should be advised about the potential risks of breakthrough vitreous hemorrhage and retinal detachment following intravitreal gas injection. Additionally, close postoperative monitoring is vital for timely identification and management of complications to optimize visual outcomes.
