The study looked at eye surgery for bleeding under the retina caused by age‑related macular degeneration or a retinal artery aneurysm. It found that most patients (85%) kept or improved their vision after the procedure, especially if they were younger, had better vision before surgery, and had smaller bleeds.

The study aimed to determine the outcomes and prognostic factors of vitrectomy, subretinal injection of tissue-plasminogen activator and gas tamponade in macular hemorrhage (MaH) due to age-related macular degeneration (AMD) or retinal arterial macroaneurysm (RAM). The study design utilized a multicentric retrospective case series design of consecutive patients undergoing surgery between 2014 and 2019. A total of 65 eyes from 65 patients were included in the study. Surgery was performed after a mean period of 7.1 days. Displacement of MaH was achieved in 82% of the eyes. Mean best-corrected visual acuity (BCVA) improved from 20/500 to 20/125 at month(M)1 and M6 (<i>p</i> &lt; 0.05). At M6, BCVA worsening was associated with an older age at diagnosis (<i>p</i> = 0.0002) and higher subretinal OCT elevation of MaH (<i>p</i> = 0.03). The use of treat and extend (TE) (OR = 16.7, <i>p</i> = 0.001) and small MaH fundus size (OR = 0.64 and 0.74 for horizontal and vertical fundus size, <i>p</i> &lt; 0.05) were predictive of a higher likelihood of obtaining a countable BCVA at M1. Baseline BCVA was predictive of postoperative BCVA (<i>p</i> &lt; 0.05). Retinal detachment and MaH recurrence occurred in 3% and 9.3% of cases at M6. MaH surgery stabilizes or improves BCVA in 85% of cases. Younger age at diagnosis, better baseline BCVA figures, smaller subretinal MaH height and use of TE regime were predictive of the best postoperative outcomes.