The effect of Nd:YAG laser membranotomy and intravitreal tissue plasminogen activator with gas on massive diabetic premacular hemorrhage.
OBJECTIVE
To investigate the combined therapeutic effects of Nd:YAG laser membranotomy and intravitreal tissue plasminogen activator (tPA) (Actilyse; Boehringer Ingelheim, Ingelheim, Germany) injection with perfluoropropane (C3F8, 100%) injection on massive diabetic premacular hemorrhage.


METHODS
Nd:YAG laser membranotomy was performed on the hemorrhagic membrane of premacular hemorrhage, and tPA (25 microg/0.1 mL) was injected into the vitreous cavity of seven eyes with massive diabetic premacular hemorrhage. For each procedure 0.2 mL of C3F8 was also injected.


RESULTS
After the combined therapy, the patients recovered vision within 4 weeks and the hemorrhages were completely absorbed within 8 weeks. Visual acuity at the last follow-up visit improved to a mean of 10 logarithm of the minimum angle of resolution lines in all cases. There were no associated ophthalmic complications.


CONCLUSIONS
The combined therapy resulted in resolution of premacular hemorrhages with proliferative diabetic retinopathy and may allow for faster resolution of premacular hemorrhages and lessen the need for vitrectomy.
Chung
Jin
J
St. Marys Eye Clinic, Uijeongbu, Korea.
Park
Young-Hoon
YH
Lee
Young-Chun
YC
D000328:Adult; D003131:Combined Modality Therapy; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005451:Fluorescein Angiography; D005466:Fluorocarbons / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D053685:Laser Therapy; D008297:Male; D008566:Membranes / Q000601:surgery; D008875:Middle Aged; D012166:Retinal Hemorrhage / Q000175:diagnosis / Q000188:drug therapy / Q000601:surgery / Q000628:therapy*; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome; D014792:Visual Acuity; D014822:Vitreous Body
D005343:Fibrinolytic Agents; D005466:Fluorocarbons; C042852:perflutren; D010959:Tissue Plasminogen Activator