A woman's sudden vision loss was caused by fatigue, but she was diagnosed with subretinal hemorrhage, which can cause blindness

The woman's eyesight suddenly deteriorated, and she thought it was caused by overwork. After nearly a month, her eyesight became worse and worse, and she went to see a doctor, but unexpectedly, it was found that it was subretinal hemorrhage that could cause blindness. Recently, the patient's eyesight improved from 0.08 to 0.3 through comprehensive treatment including surgery.

Ms. Cheng, 52 years old this year, lives in Xianning. A month ago, she suddenly experienced a decrease in vision in her right eye. At first, she thought it was caused by overwork, but she never got better. Last week, accompanied by her family, Ms. Cheng came to the Aier Eye Hospital affiliated to Wuhan University. After examination, her naked eye vision in the right eye was 0.08. Through OCT, fundus photography and other examinations, it was found that there was a hemorrhage under the retina in the macula of her right eye. After a careful examination, Li Xiangyun, deputy chief physician of the fundus disease department of the hospital, said that Ms. Cheng had subretinal hemorrhage in the right eye, idiopathic polypoidal choroidal vasculopathy in the right eye, and cataracts in both eyes, and needed to be hospitalized for treatment.

Director Li Xiangyun said that subretinal hemorrhage can cause irreversible damage to the retina, especially the macular area which is closely related to vision. The vision of some patients is reduced to light sensitivity overnight, which has a great impact on vision.

After consultation with experts before the operation, a minimally invasive vitrectomy combined with 38G ultra-fine needle subretinal injection of t-PA (tissue plasminogen activator) and anti-VEGF treatment was finally developed for Ms. Cheng. It is understood that after vitrectomy, this operation finds the highest point of the retinal protrusion (avoiding the center of the macula), locally peels off the internal limiting membrane, uses a 38G needle to gently pierce the subretina, and slowly injects t-PA into the subretina. In this step of the operation, the expert will use a special syringe and a more stable pneumatic push method to gently inject the drug into the subretina, which will reduce the occurrence of complications such as iatrogenic tears and retinal pigment epithelial damage.

Last Friday, Wu Jianhua, director of Wuhan University Aier Eye Hospital, and Li Xiangyun, director, successfully performed a minimally invasive vitrectomy on Ms. Cheng's right eye under local anesthesia, combined with 38G subretinal injection of t-PA and intravitreal injection of anti-VEGF drugs.

On the third day after the operation, the macular hemorrhage in Ms. Cheng's right eye completely disappeared, the macular structure was basically restored, and the vision of the right eye also improved to 0.3.

Director Li Xiangyun introduced that polypoidal choroidal vasculopathy is an eye fundus disease that mainly occurs in middle-aged and elderly people. There may be no obvious symptoms in the early stage, and some patients are accidentally discovered during fundus examination. If the lesion is located in the center of the macula or near it, there may be a gradual decrease in vision or visual distortion. The usual treatment is intraocular injection of anti-VEGF drugs. If vitreous hemorrhage occurs, vision may suddenly and severely decrease. Treatment must remove blood and blood clots in the vitreous cavity and macula as soon as possible to reduce damage to retinal photoreceptor cells and preserve vision to the maximum extent. Therefore, surgical methods are often used in clinical treatment of this situation. This time, vitrectomy combined with subretinal injection of t-PA and intravitreal injection of anti-VEGF drugs gave patients better postoperative results.

She reminded that polypoidal choroidal vasculopathy is more common in people over 60 years old. It is a degenerative disease that occurs with age and is hard to prevent. If middle-aged and elderly people experience a gradual decline in vision, or cannot see objects clearly or objects become deformed, they should go to the hospital in time for treatment. At the same time, quitting smoking, controlling blood sugar and blood pressure, maintaining good nutrition, exercising appropriately, and maintaining a good mood are very helpful in reducing the probability of disease.