Intravitreal injection of tissue plasminogen activator and gas in subretinal hemorrhage caused by age-related macular degeneration.
OBJECTIVE
To assess the efficacy and safety of intravitreal injection of recombinant tissue plasminogen activator and sulfur hexafluoride gas for displacement of subretinal hemorrhages in patients with age-related macular degeneration.


METHODS
The authors injected 25 microg of recombinant tissue plasminogen activator and 0.5 mL sulfur hexafluoride gas intravitreally in 11 patients with subretinal hemorrhages of less than 3 weeks duration. Anatomic and functional results were evaluated.


RESULTS
Displacement of subretinal blood was successful within the first week after surgery in 10 of 11 patients. This was accompanied by visual improvement in eight patients. After 1 year, visual acuity was better than before surgery in five patients. Diagnosis of a choroidal neovascularization by fluorescein angiography was possible in all patients, and was treated with laser photocoagulation in five. The authors observed no adverse effects of treatment.


CONCLUSIONS
Recombinant tissue plasminogen activator and gas effectively displace subretinal blood in patients with age-related macular degeneration. Randomized studies are necessary to prove the benefit of this simple and safe method in patients with subretinal hemorrhage due to age-related macular degeneration.
Krepler
K
K
Department of Ophthalmology, University of Vienna, Austria.
Kruger
A
A
Tittl
M
M
Stur
M
M
Wedrich
A
A
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005451:Fluorescein Angiography; D006801:Humans; D007267:Injections; D008268:Macular Degeneration / Q000150:complications*; D008297:Male; D010865:Pilot Projects; D011994:Recombinant Proteins / Q000627:therapeutic use; D012166:Retinal Hemorrhage / Q000188:drug therapy* / Q000209:etiology; D013459:Sulfur Hexafluoride / Q000008:administration & dosage*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014792:Visual Acuity; D014822:Vitreous Body
D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator; D013459:Sulfur Hexafluoride