[Intra-vitreal rt-PA and gas introduction in submacular hemorrhage].
Efficacy and complications of intravitreally injected tissue plasminogen activator (rt-PA) and sulfahexafluoride gas (SF6) in submacular hemorrhage are demonstrated.


METHODS
Fifty-three patients with submacular hemorrhage were treated (27 women, 26 men, mean age 79 +/- 1 years). Causes of hemorrhage were a choroidal neovascularization in 47 patients and macroaneurysm in 6 patients. After i.v. administration of 500 mg acetazolamide and disinfection of the conjunctiva, 50 micrograms rt-PA in 0.1 ml (BSS) and 0.5 ml SF6 were injected intravitreally. The patient was positioned prone for 24 h.


RESULTS
In 23 patients with choroidal neovascularization visual acuity improved by 2 lines and more; in 12 patients vision remained unchanged. In 12 patients visual acuity deteriorated. In 5 of 6 patients with a macroaneurysm vision improved from less than 0.1 to 0.1-0.5. Postoperative complications were four cases of vitreous hemorrhage and one case of endophthalmitis.


CONCLUSIONS
The intravitreal injection of rt-PA and SF6 is an alternative method for treatment of submacular hemorrhage.
Buhl
M
M
Universitäts-Augenklinik München.
Scheider
A
A
Schönfeld
C L
CL
Kampik
A
A
D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000628:therapy; D020256:Choroidal Neovascularization / Q000628:therapy*; D005260:Female; D006801:Humans; D007267:Injections; D008297:Male; D011994:Recombinant Proteins; D012162:Retinal Degeneration / Q000628:therapy*; D012166:Retinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D013459:Sulfur Hexafluoride / Q000008:administration & dosage*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome; D014822:Vitreous Body
D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator; D013459:Sulfur Hexafluoride