Résumé
Objectives: to evaluate efficacy and security of submacular hemorrhage’s (SMH) surgical treatment and to determine preoperative prognosis factors.Materials and methods: retrospective multicentric study from January 1st, 2015, to July 1st, 2022. We included all patients diagnosed with SMH and treated by pars plana vitrectomy, subretinal recombinant tissue plasminogen activator (rtPA) and pneumatic displacement. Data recorded were preoperative demographic parameters, SMH characteristics, visual and optical coherence tomography changes at 1, 3, 6 and 12 months, and complications.Results: 37 eyes of 35 patients were included in this study. The underlying ocular diagnosis were age related macular degeneration (54%), macroaneuvrysm (22%), post traumatic (16%) and polypoidal choroidal vasculopathy (8%). The best corrected visual acuity (BCVA) improved significantly at 1 month (1,11±0,77 vs 1,8±0,54, p<0,001). This trend was verified at postoperative 3, 6 and 12 months. A foveal displacement of the hemorrhage was achieved in 29 cases (80,6%) and central macular thickness significant decrease at 1 month (p<0,001). Correlation and logistic regression analyses showed that initial visual acuity (p<0,01), SMH size (p=0,022), area (p=0,018) and time to treatment inferior to 7 days (p=0,049) were associated with greater visual outcomes at 1 month. Conclusion: we showed a functional and anatomical improvement after surgical management of SMH. Initial visual acuity, SMH area and thickness and early treatment are associated with the visual prognosis of submacular hemorrhage.