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Comment. The size of the submacular hemorrhage has not been shown to affect the outcome of this procedure. Hassan et al showed good results even in large, thick submacular hemorrhages. There are conflicting reports with regard to the duration of submacular hemorrhage. In a series by Hattenbach et al, no eyes with a submacular hemorrhage duration longer than 21 days showed any improvement. However, in a series of 104 eyes, Chen et al did not find significant correlation with the duration of hemorrhage but most of the eyes were treated within 4 weeks. Despite the conflict, our case illustrates that it is worthwhile to attempt the use of tPA with gas even in longerlasting hemorrhages where observation alone will likely lead to gross reduction of vision.

Ten-Year Evolution of Retinopathy Lesions in an Older Nondiabetic Population