Role of posterior vitreous detachment induced by intravitreal tissue plasminogen activator in macular edema with central retinal vein occlusion.
OBJECTIVE
To evaluate the effects of posterior vitreous detachment (PVD) in macular edema associated with central retinal vein occlusion (CRVO) treated with intravitreal tissue plasminogen activator (tPA).


METHODS
The authors conducted a retrospective study of 36 eyes of 36 patients with macular edema by CRVO treated with intravitreal tPA. In 16 of 21 eyes without pretreatment PVD, PVD developed after the treatment. Multiple linear regression analysis was used to evaluate the correlation between logarithm of the minimum angle of resolution (logMAR) visual acuity (VA) changes and several variables.


RESULTS
The VA and macular thickness significantly improved after treatment. The pretreatment logMAR VA (R = 0.646; P < 0.0001), PVD development after tPA (R = -0.303; P = 0.025), and age (R = 0.255; P = 0.050) correlated with the logMAR VA at final visit. The greater improvement in logMAR VA was correlated only with PVD development (R = 0.467; P = 0.0041). Macular thickness in the eyes with PVD development was significantly less than without PVD development at the 6-month visit and the end of follow-up.


CONCLUSIONS
The findings suggest that PVD development after intravitreal tPA may partly contribute to the resolution of macular edema and a better VA outcome.
Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Kyoto University, Japan.
Tomoaki
T
Murakami
Hitoshi
H
Takagi
Hirokazu
H
Ohashi
Mihori
M
Kita
Hirokazu
H
Nishiwaki
Kazuaki
K
Miyamoto
Daisuke
D
Watanabe
Atsushi
A
Sakamoto
Noritatsu
N
Yamaike
Nagahisa
N
Yoshimura
D000368:Aged; D005260:Female; D005343:Fibrinolytic Agents; D006801:Humans; D007267:Injections; D008269:Macular Edema / Q000209:etiology / Q000503:physiopathology*; D008297:Male; D012170:Retinal Vein Occlusion / Q000150:complications / Q000503:physiopathology*; D012189:Retrospective Studies; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014822:Vitreous Body / Q000187:drug effects; D020255:Vitreous Detachment / Q000139:chemically induced / Q000503:physiopathology*
D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator