Pneumatic Displacement and Intra-vitreal Bevacizumab in Management of Sub-retinal and Sub-retinal Pigment Epithelial Hemorrhage at Macula in Polypoidal Choroidal Vasculopathy (PCV): Rationale and Outcome.

We report three cases of submacular haemorrhage due to polypoidal choroidal vasculopathy (PCV) treated with intravitreal bevacizumab and pneumatic displacement with perfluoropropane (C₃F₈) gas. The patients were between 45 to 55 years and presented with reduction of vision (20/400 to 20/80) within two weeks of onset of symptoms. The submacular (sub-retinal plus sub-retinal pigment epithelium [RPE]) hemorrhages was confirmed as PCV on indocyanine green angiography and optical coherence tomography in all of them. They were treated with intravitreal bevacizumab (1.25 mg/0.05 ml) and 0.3 ml of 100% C₃F₈ gas in the affected eye followed by prone positioning for two weeks. The vision and macular anatomy started improving within a week and continued up to three months. These cases demonstrate that pneumatic displacement combined with intravitreal anti-VEGF injection could be a promising option in patients with PCV and sub-macular blood, even when the blood is beneath the RPE. [ABSTRACT FROM AUTHOR]