Initial clinical experience with tissue plasminogen activator (tPA) assisted removal of submacular haemorrhage.
Tissue plasminogen activator (tPA) (250 micrograms/ml) was used to facilitate removal of submacular thrombus in 15 patients. Following a three-port vitrectomy and subretinal tPA injection (0.1 ml) via a 30 gauge needle, blood was evacuated after enzymatic dissolution for 20 minutes. Two injections were required in some cases. Nine women and six men were treated (mean age 75.5 +/- 8.6 years). Duration of symptoms ranged from 2 days to 8 weeks. One case was due to a retinal macroaneurysm, the others to age-related macular degeneration. Vision improved in 13 patients and remained the same or deteriorated in 2 (mean follow-up 11 +/- 4.9 months). Well-defined subretinal neovascular membranes were identified in 2 patients and occult neovascularisation suspected in 2 others. A cataract developed in 1 case and retinal detachments in 2 others; all were treated successfully. The poor visual prognosis associated with submacular haemorrhage may be obviated by the use of the technique we describe.
St Paul's Eye Unit, Royal Liverpool University Hospital, UK.
A P
AP
Moriarty
I L
IL
McAllister
I J
IJ
Constable
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008268:Macular Degeneration / Q000150:complications; D008297:Male; D008875:Middle Aged; D010960:Plasminogen Activators / Q000627:therapeutic use*; D011379:Prognosis; D012164:Retinal Diseases / Q000188:drug therapy; D012166:Retinal Hemorrhage / Q000150:complications*; D015912:Thrombolytic Therapy; D013927:Thrombosis / Q000188:drug therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014792:Visual Acuity
D010960:Plasminogen Activators; D010959:Tissue Plasminogen Activator