Vitreous hemorrhage after intravitreal tissue plasminogen activator (t-PA) and pneumatic displacement of submacular hemorrhage.
OBJECTIVE
To report the immediate complication of dense vitreous hemorrhage after intravitreal injection of tissue plasminogen activator and gas for treatment of two cases of sudden submacular hemorrhage associated with retinal arterial macroaneurysm.


METHODS
Case reports.


RESULTS
Two patients, a 67-year-old woman and a 92-year-old man, presented with sudden vision loss related to submacular hemorrhage from a retinal macroaneurysm. Tissue plasminogen activator at a dose of 50 microg to 75 microg and a sulfur hexafluoride (SF(6)) gas bubble were injected intravitreally under local anesthesia. Dense vitreous hemorrhage was noted on the first postoperative day in both cases, which subsequently required pars plana vitrectomy removal.


CONCLUSIONS
Sudden severe vitreous hemorrhage may be an immediate complication after intravitreal injection of tissue plasminogen activator and gas for treatment of submacular hemorrhage associated with retinal arterial macroaneurysm.
Kokame
G T
GT
Division of Ophthalmology, Department of Surgery, University of Hawaii School of Medicine, Honolulu, Hawaii, USA.
D000368:Aged; D000369:Aged, 80 and over; D000783:Aneurysm / Q000150:complications / Q000473:pathology; D005260:Female; D005343:Fibrinolytic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007267:Injections; D008266:Macula Lutea; D008297:Male; D012161:Retinal Artery / Q000473:pathology; D012166:Retinal Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D013459:Sulfur Hexafluoride / Q000009:adverse effects* / Q000627:therapeutic use; D010959:Tissue Plasminogen Activator / Q000009:adverse effects*; D014821:Vitrectomy; D014823:Vitreous Hemorrhage / Q000139:chemically induced* / Q000601:surgery
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator; D013459:Sulfur Hexafluoride