Pneumatic displacement of a dense sub-inner limiting membrane pre-macular hemorrhage in dengue maculopathy- A novel treatment approach

Sub-ILM haemorrhage is a rare presenting feature of dengue maculopathy. A 24 yr old male, active military personnel recently treated as case of dengue hemorrhagic fever presented with sub-ILM bleed in right eye (dominant eye) with profound diminution of vision. SD-OCT and FFA confirmed sub-ILM bleed without any evidence of vasculitis/venous occlusion or neovascularisation. He consented against active surgical management of pars plana vitrectomy and was treated with pneumatic temponade of C3F8 (100%) gas with prone positioning in order to achieve faster visual recovery. He responded well to treatment with complete visual recovery in 01 week. This case report documents for the first time treatment of sub-ILM bleed in pre-macular area with pneumatic temponade with prone positioning leading to rapid and complete visual recovery in patient of dengue maculopathy, which can be employed for patients who cannot be subjected to more active surgical management approach.