Characteristics of submacular hemorrhage with bacillary layer detachment and intrabacillary hemorrhage.

Purpose: To study the outcomes of patients presenting with submacular hemorrhage (SMH) and bacillary layer detachment (BALAD) following intervention.

Methods: This retrospective study examined fundus photographs and optical coherence tomography (OCT) scans to identify treatment-naive SMH and BALAD cases. Two groups were formed: SMH cases with and without BALAD. The treatment outcomes of these cases were assessed.

Results: Thirteen (65%) of the 20 eyes with SMH had BALAD. Blunt trauma was the most common cause of SMH (n = 10, 50%). Median age was 46 years (IQR range: 28-70). Demographic, clinical, or OCT imaging findings between the groups (p > 0.05) were comparable. Nine (45%) patients each underwent intravitreal gas injection alone or along with PPV and TpA injection. At 1-month post-treatment, VA improved (logMAR VA - 0.89; p = 0.017). BALADs and intrabacillary hemorrhage had resolved in eight (61%) cases. Intraretinal, subretinal, and sub-RPE fluids resolved in 100%, 70%, and 43% of cases, respectively. Eyes with resolved BALAD showed greater improvement in VA (logMAR VA - 0.98) than eyes with persisting BALAD (logMAR VA - 1.1) and resulted in significant decrease in central macular (p = 0.016) and retinal thicknesses (p = 0.031). SMH eyes without pre-treatment BALAD also observed statistically significant improvement in visual acuity following intervention (p = 0.031).

Conclusion: BALAD and intrabacillary hemorrhage in SMH are relatively common. A significant proportion of cases had their BALAD and intrabacillary haemorrhage resolved following treatment. Persistence of BALAD had no effect on VA.