[Management of submacular hemorrhage by tissue plasminogen activator and SF(6) gas injection].
The formation of platelet-fibrin clots causes degeneration of foveolar photoreceptors by subretinal hemorrhage.


METHODS
Twenty-two patients with submacular hemorrhages were treated by intravitreal injection of 50 microg tpa and 0.5 ml SF(6) gas within 1 h. Biomicroscopy, fundus photography and fluorescein angiography were performed pre- and postoperatively. Further multifocal electroretinograms were recorded.


RESULTS
The subfoveolar hemorrhages were dissoluted and displaced out of the macular region. The visual acuity increased in 18 cases and ranged from hand movement and 0.3 to values between 1/10 and 0.5.


CONCLUSIONS
Toxic and hypoxic damage of foveolar photoreceptors by subretinal hemorrhage can be prevented by early and minimal invasive fibrinolytic therapy. After localization of choroidal neovascularizations, treatment by focal laser coagulation is possible in some cases.
Meier
P
P
Universitäts-Augenklinik, Leipzig.
Zeumer
C
C
Jochmann
C
C
Wiedemann
P
P
D000368:Aged; D004596:Electroretinography; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D007267:Injections; D017075:Laser Coagulation; D008268:Macular Degeneration / Q000150:complications*; D008297:Male; D012166:Retinal Hemorrhage / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D013459:Sulfur Hexafluoride / Q000008:administration & dosage*; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D014792:Visual Acuity; D014822:Vitreous Body
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator; D013459:Sulfur Hexafluoride