Management of large submacular hemorrhage in a patient undergoing neurosurgical intervention for moyamoya

We report the case of a 30-year-old woman with diabetes and newly diagnosed moyamoya disease who experienced submacular hemorrhage and acute vision loss. She presented with facial droop and slurred speech, and examination disclosed high-grade stenosis of the intracranial carotid artery. She was scheduled for urgent neurosurgery. The day before surgery, she lost vision in her left eye and was found to have diffuse multilayered hemorrhage with submacular hemorrhage. Pneumatic displacement was performed. Pars plana vitrectomy and drainage of the submacular hemorrhage were performed subsequently, with postoperative improvement in vision.