Vitrectomy with Subretinal Tissue Plasminogen Activator for Submacular Hemorrhage: A Multicenter Retrospective Analysis of Functional and Anatomical Outcomes Across Multiple Etiologies

PPV with subretinal tPA achieved rapid hemorrhage clearance, significant visual gain, and durable anatomical restoration with minimal complications and limited anti-VEGF need. It offers an effective, safe option for large SMH across etiologies, enabling timely foveal recovery and improved long-term functional outcomes.