An Innovatory Surgical Technique for Submacular Hemorrhage Displacement by Means of a Bioengineering Perspective

The purpose of this case report is to present a new surgical technique for the treatment of large Subretinal Hemorrhage (SRH) secondary to Age-related Macular Degeneration (AMD). Considering the biomechanics of foam evolution theory, bubble coarsening effect, and gas–liquid biphasic absorption, an SRH due to an AMD case was treated with vitrectomy. The treatment was implemented by subretinal injection of air bubbles combined with rtPA followed by air fluid exchange. The air bubbles helped mess up and remove the blood from the macula area, and no complications occurred. Two weeks postoperatively, there was no sign of hemorrhage and the Central Macular Thickness (CMT) was sharply decreased from 443 μm to 317 μm. At the five-month follow-up, the CMT remained at 267 μm and the patient’s visual acuity improved from light perception to 20/70 according to the Snellen chart. The combination of injecting multiple air bubbles and submacular rtPA, followed by air fluid exchange, was able to displace more than (90%) of the subretinal blood just two weeks postoperatively. Our technique is a promising alternative surgical approach for the displacement of SMH due to AMD, with a clear visual and anatomical benefit seen in the early follow-up period.

Quantitative OCT Angiography of Retina Vessel Density for Early Glaucoma Diagnosis

Glaucoma is the leading cause of irreversible blindness worldwide. Developed recently, OCTA is a promising non-invasive eye imaging tool for glaucoma diagnosis in the early stage. This research designed a diagnosis support software based on analyzing color-density map and ROIs vessel density index on the OCTA images scanned peripapillary and macula area. Hessian-based filter and Otsu thresholding were used to detect and enhance small vessels. The program greatly detected areas of vascular dropout on glaucoma eyes.