To investigate the efficiency of 577 nm semiconductor laser membranotomy for macular sub-inner limiting membrane (ILM) hemorrhage.

From January 2017 to March 2021, 10 patients (10 eyes) with macular sub-ILM hemorrhage diagnosed in Beijing Tongren Eye Center, Beijing Tongren Hospital affiliated to Capital Medical University were enrolled. There were 6 males (6 eyes) and 4 females (4 eyes) with the average age of (47.8±18.5) years-old (ranged from 15 to 78 years-old). All patients were treated with 577nm laser membranotomy. While the membranotomy failed, patients with macular hole, or vitreous blood failed to absorb for more than one month, they were underwent vitrectomy. The best corrected visual acuity (BCVA), intraocular pressure, anterior segment, fundus and optical coherence tomography (OCT) of patients were examined before and after treatment. The clinical data were described by frequency and percentage.

Among of 10 patients (10 eyes) the preoperative diagnosis, 4 cases (4 eyes) were Valsalva retinopathy; 3 cases (3 eyes)were diabetic retinopathy; 2 cases (2 eyes) were retinal artery aneurysms; 1 case (1 eye) was unknown, accounting for 40% (4/10), 30% (3/10), 20% (2/10) and 10% (1/10), respectively. The duration of sub-ILM hemorrhage ranged from 1 to 60 days. Of 10 patients (10 eyes) were treated with 577 nm laser, 9 patients were successful in drainage, accounting for 90% (9/10); one case was failed, accounting for 10% (1/10). Among of them, 5 cases were successful in drainage at the time of laser, accounting for 50% (5/10). 4 cases had successful drainage within one week after laser, accounting for 40% (4/10). One case with macular hole was found after laser and then underwent vitrectomy, accounting for 10% (1/10). 3 cases were vitreous hemorrhage, accounting for 30% (3/10). 2 cases were underwent vitrectomy, accounting for 20% (2/10). 1 case underwent vitreous lavage, accounting for 10% (1/10). One case was found to have epimacular membrane after operation but no further for surgery, accounting for 10% (1/10).

The treatment of macular sub-ILM hemorrhage includes conservative treatment, laser membranotomy and vitrectomy. The application of 577 nm laser membranotomy with appropriate treatment time and rational laser parameters could successfully drain the sub-ILM hemorrhage. At the same time, the complications of laser treatment and timely vitrectomy should be paid attention.