title: Tissue plasminogen activating factor assisted removal of subretinal hemorrhage.
abstract: We used tissue plasminogen activator (tPA) to aid in the surgical evacuation of subretinal hemorrhages. Subretinal hemorrhage secondary to a ruptured retinal macroaneurysm was treated in two patients. The surgical technique involved using a micropipette to fashion a small retinotomy through which tPA was injected into the subretinal space and through which the dissolved clot was removed. Visual acuity improved from counts fingers to 20/50 in one patient and from counts fingers to 20/70 in the other. Three additional patients, with massive subretinal hemorrhages secondary to age-related macular degeneration, were similarly treated. In one, visual acuity improved from counts fingers to 20/400; in two others, visual acuity was stabilized; in the first patient, at 20/300, and in the second patient at 20/400. The use of tPA minimizes surgical manipulation of the sensory retina and greatly reduces the size of the retinotomy required for evacuation of subretinal blood.
authors.affiliation: LSU Eye Center, Louisiana State University Medical Center School of Medicine, New Orleans.
authors.forename: G A
authors.initials: GA
authors.lastname: Peyman
authors.forename: N C
authors.initials: NC
authors.lastname: Nelson
authors.forename: W
authors.initials: W
authors.lastname: Alturki
authors.forename: K J
authors.initials: KJ
authors.lastname: Blinder
authors.forename: C L
authors.initials: CL
authors.lastname: Paris
authors.forename: U R
authors.initials: UR
authors.lastname: Desai
authors.forename: C A
authors.initials: CA
authors.lastname: Harper
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000150:complications; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D007431:Intraoperative Complications; D008268:Macular Degeneration / Q000150:complications; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012163:Retinal Detachment / Q000000981:diagnostic imaging; D012166:Retinal Hemorrhage / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D012171:Retinal Vessels; D012422:Rupture, Spontaneous; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014463:Ultrasonography; D014792:Visual Acuity; D014794:Visual Fields
chemical_list: D010959:Tissue Plasminogen Activator