Nd:YAG-Laserung einer retrohyaloidalen Blutung nach Venenastverschluss [Nd:YAG Laser for Retrohyaloidal Haemorrhage after Retinal Branch Vein Occlusion]

Background: A retrohyaloidal haemorrhage can be caused by different underlying diseases. Usually dense haemorrhages are treated by early vitrectomy. We want to report the successful treatment of a retrohyaloidal haemorrhage by means of Nd:YAG laser membranotomy. Materials and Methods: A 47-year-old man noticed two weeks before presentation a sudden visual loss in the left eye. Visual acuity on the first visit was c. c. 20/32 OD and c. c. 20/400 ex. OS. Dilated fundus examination of the left eye showed multiple intraretinal haemorrhages in the superior periphery and a dense retrohyaloidal haemorrhage over the macula. Anamnestic risk factors for ocular bleeding were systemic hypertension in connection with adiposity. Results: A retinal branch vein occlusion with retrohyaloidal haemorrhage due to systemic hypertension was diagnosed. To drain the retrohyaloidal haemorrhage into the vitreous an Nd:YAG laser membranotomy of the anterior surface of the haemorrhage was performed. Visual acuity increased to 20/100 within 30 min. Conclusion: Possible therapeutic options to manage retrohyaloidal haemorrhages are observation, primary vitrectomy and Nd:YAG laser membranotomy. The presented case shows laser membranotomy to be a promising possibility for a rapid resolution of retrohyaloidal haemorrhage in selected patients