To present the management and outcomes of a case of acute submacular hemorrhage due to neovascular age-related macular degeneration (nAMD). A single case was retrospectively evaluated. A 79-year-old man with a history of submacular hemorrhage from nAMD and persistent disease activity in the left eye presented with acute submacular hemorrhage in his better-seeing right eye, which was previously closely monitored for an extrafoveal serous pigment epithelial detachment without exudation. The patient received intravitreal antivascular endothelial growth factor (anti-VEGF) and subsequently had pars plana vitrectomy with subretinal tissue plasminogen activator and gas tamponade. After 5 days of face-down positioning, the hemorrhage was successfully displaced from the fovea. Recurrent disease activity 2 weeks postoperatively prompted intensive biweekly anti-VEGF therapy. By postoperative month 5, the patient's visual acuity improved from 20/400 to 20/70 OD. This case highlights the importance of close monitoring of patients with nAMD exhibiting aggressive disease as well as the efficacy of prompt surgical intervention and increased anti-VEGF frequency for large submacular hemorrhages.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11625403PMC
http://dx.doi.org/10.1177/24741264241305103DOI Listing

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