Managing Massive Subretinal Hemorrhage Without Surgery

Two patients with massive subretinal hemorrhage demonstrated sustained long-term stability following intravitreal anti-VEGF monotherapy.

By: Michael Y. Zhao, MD, Harry W. Flynn Jr., MD

Retinal Physician July 1, 2026 Vol 23, Issue July-August 2026 Page(s): 22-25

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Massive subretinal hemorrhage (mSRH) is defined as hemorrhage exceeding 3 to 4 disc diameters and is associated with poor visual prognosis.
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Two patients with mSRH were successfully managed with intravitreal anti-VEGF monotherapy and showed long-term stability over 10 to 20 years.
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The most common cause of mSRH is neovascular age-related macular degeneration, but other causes include retinal arterial macroaneurysms and polypoidal choroidal vasculopathy.
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Anti-VEGF therapy has shown good efficacy and safety in treating mSRH, with studies indicating better early visual recovery compared to other treatment strategies.
5

Prompt treatment of mSRH is critical to prevent irreversible photoreceptor damage and improve visual outcomes.

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