title: Intravitreal tissue plasminogen activator in the management of central retinal vein occlusion.
abstract: OBJECTIVE
  To evaluate the role of intravitreal tissue plasminogen activator (tPA) in the management of central retinal vein occlusion (CRVO) in patients with symptoms for <3 days.
  
  
  METHODS
  We evaluated the visual outcome of a consecutive series of patients with CRVO following intravitreal tPA injection. All patients presented with visual acuity worse than 20/50 within 3 days from the onset of symptoms. Main outcome measures included percentage of patients whose final vision improved to 20/50 or better and change in percentage of patients with vision of 20/200 or worse before and after treatment.
  
  
  RESULTS
  Twelve patients received intravitreal tPA for CRVO. Nine patients (75%) had best-corrected visual acuity of 20/200 or worse at presentation compared with 4 patients (33%) at the last follow-up after treatment. Five (55%) of these 9 patients had final visual acuity that improved to 20/50 or better. The remaining four patients did not have improvement or their vision continued to worsen. All 4 patients had fluorescein angiographic evidence of >10 disk areas of capillary nonperfusion at presentation. Overall, 8 (67%) of 12 patients had final visual acuity of 20/50 or better. No side effects related to tPA injection were observed.
  
  
  CONCLUSIONS
  Our data suggest that intravitreal tPA injection may have a beneficial role in the management of CRVO when used within a few days of the onset of symptoms in patients with no angiographic evidence of severe capillary nonperfusion even if initial visual acuity is 20/200 or worse.
authors.affiliation: Department of Ophthlamology, American University of Beirut, Lebanon.
authors.forename: Nicola G
authors.initials: NG
authors.lastname: Ghazi
authors.forename: Baha'n
authors.initials: B
authors.lastname: Noureddine
authors.forename: Randa S
authors.initials: RS
authors.lastname: Haddad
authors.forename: Fadi A
authors.initials: FA
authors.lastname: Jurdi
authors.forename: Ziad F
authors.initials: ZF
authors.lastname: Bashshur
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004341:Drug Evaluation; D005260:Female; D005342:Fibrinolysis; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005451:Fluorescein Angiography; D006801:Humans; D007267:Injections; D008297:Male; D008875:Middle Aged; D012170:Retinal Vein Occlusion / Q000188:drug therapy*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D014792:Visual Acuity; D014822:Vitreous Body
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator