Abstract

P 257

Titel fehlt

Sebastian Kramer, Stephan Hoffmann, Sebastian Walter, Andreas Christian Schroeder, Berthold Seitz
Klinik für Augenheilkunde, Universitätskliniken des Saarlandes, Homburg/Saar

Objective
Subhyaloidal bleeding in the macular area is a common problem of patients with proliferative diabetic retinopathy (PDR). Furthermore, the subhyaloidal bleeding is sometimes related to impaired blood clotting diseases. A subhyaloidal bleeding in the macular area leads to an impaired vision of the patient. In contrast plana vtrectomy (PPV), minimal invasive techniques are available for the treatment of the disease. Argon laser hyaloidotomie is one of this minimal invasive techniques leading to improvement of vision.
Methods
In January 2009, a 54-year-old caucasian male was sent to our department with a massive impairment of vision after a subhyaloidal bleeding in the macular area of the right eye.  The patient had a insulin- dependent diabetes mellitus since 1995. The latest Hba1c level was 9.5%. In the past, two sessions of panretinal laser coagulation had been performed on both eyes because of PDR. An Argon-laser hyaloidotomy of the right eye was performed to improve the vision. Directly postoperatively, the subhyaloidal blood in the macular region leaked into the inferior part of the vitreous cavity.
Results
Vision improved from hand motion to a Snellen equivalent of 0.8 during a time course of 10 minutes. The subhyaloidal blood in the macular region had totally vanished at the second day after Argon-laser hyaloidotomy. Only a small parapapillary bleeding was seen on funduscopy. Vision improved to a Snellen equivalent of 1.0 and remained stable.
Conclusions
Argon-laser hyaloidotomie is a safe and effective therapeutic procedure to treat subhyaloidal bleeding in the macular area. A rapid vision improvement can be seen directly postoperatively. Therefore, a more invasive procedure as PPV can be relinquished. In addition, the disadvantages of YAG-laser hyaloidotomy with a possible pressure wave leading to damage next to the fovea can be avoided.

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