PMC3392917_01
Fundus findings of the left eye before ranibizumab treatment. Fundus photographs (A) and (B) depict age-related macular degeneration (A) and subretinal hemorrhage (B) in temporal inferior region of macula. Fluorescein angiographic (C) and (D) and indocyanine green angiographic (E) and (F) findings reveal choroidal neovascularization corresponding (arrows) to the region of subretinal hemorrhage.
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Fundus examination revealed extensive subretinal hemorrhage in the inferior temporal region near the arcade vessels of the left eye (Figure 1A and B) and exudative age-related macular degeneration with a fibrotic scar in the left eye. Fibrotic macular degeneration was also observed in the left eye (Figure 1A), which might have resulted from vitrectomy for removal of subretinal hematoma associated with age-related macular degeneration 4 years earlier. Fluorescein angiography and indocyanine angiography revealed choroidal neovascularization corresponding to the region of subretinal hemorrhage (Figure 1A-F).
Fundus findings of the left eye after the first intravitreal ranibizumab injection.. Note: Subretinal hemorrhage outside the arcade vessels has obviously decreased, and the hemorrhagic area has become smaller than before treatment.
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After the first intravitreal injection of ranibizumab, the subretinal hemorrhage was obviously reduced compared with before treatment (Figure 2).
Fundus findings after three intravitreal ranibizumab injections. Fundus photographs (A) and (B) show disappearance of subretinal hemorrhage. No choroidal neovascularization and subretinal hemorrhage in the corresponding area are seen on fluorescein angiography (D) and indocyanine green angiography (F). However, there are some choroidal neovascularizations (arrows) in the posterior pole of the left eye (C) and (E).
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After the third injection, ophthalmoscopic examination showed complete resolution of subretinal hemorrhage ( Figure 3A and B), and fluorescein angiography and indocyanine angiography showed reduction of choroidal neovascularization corresponding to the region of subretinal hemorrhage before treatment (Figure 3C-F), although best-corrected visual acuity in the left eye remained unchanged at 1/20 because of fibrotic macular degeneration.