To evaluate the effect of intravitreal expansile gas (C₃F₈) with anti-VEGF injection for the treatment of large submacular hemorrhage (SMH) secondary to age-related macular degeneration (ARMD).

In this report, 18 eyes of 18 patients with large SMH secondary to ARMD were treated with a simultaneous injection of 0.3 cc C₃F₈ and 0.05 ml anti-VEGF intravitrealy.

The mean age was 64.89 ± 5.68 years and the mean size of SMH was 4.44 ± 1.25 disc diameters (DD). The minimum follow-up period was 12 months (range: 12-17 months). Mean preoperative best corrected visual acuity (BCVA) was 1.72 ± 0.56 log MAR which improved significantly to 1.01 ± 0.68 log MAR at 12 months ( p = 0.002). SMH displacement occurred in all eyes. BCVA improved 2 or more lines in 11 eyes (61.1%) and deteriorated in 1 eye (5.6%).

In this report, intravitreal injection of an expansible gas (C₃F₈) with anti-VEGF produced successful results in anatomical displacement of SMH and early visual improvement.