Image of the Month: February 2024 - Submacular Hemorrhage

• This image that Ryan took is from a 81 yo M patient of Dr. Thompson's. There is a large submacular hemorrhage (SMH) depicted.
• Submacular hemorrhages can occur for many different reasons with wet AMD as the most common cause we see in our practice, like in this patient. Underlying blood abnormalities such as anemia or being on blood thinners of various kinds can contribute to SMHs that are much larger than otherwise. When SMHs are large like this case, there can be profound vision impairment.
• Treatment can be tricky and has to be individualized to each patient. Options may include anti-VEGF medication, pneumatic gas displacement, or surgery with vitrectomy and tPA (tissue plasminogen activator) administration. Sometimes, only observation is recommended.