title: Tissue plasminogen activator-assisted vitrectomy: surgical drainage of submacular hemorrhage.
abstract: A thick subretinal hemorrhage involving the macula is currently treated with pneumatic displacement or surgical removal. We evaluated the long-term effects of tPA-assisted surgical drainage of a submacular hemorrhage by reviewing the medical records of 12 eyes with submacular hemorrhage followed for a mean follow-up time of 6.9 years. The final best corrected visual acuity (BCVA) improved in 10 eyes (83%), was unchanged in 2 (17%), and was reduced in 0 (0%). The mean preoperative BCVA was 6/200, and the best postoperative BCVA was 20/47, and the final BCVA was 20/143. The late postoperative complications, including recurrent submacular hemorrhage, enlargement of the CNV, and retinal degeneration, reduced the final BCVA. These results indicate that tPA-assisted surgical removal of a subretinal hemorrhage can lead to improved long-term vision. Controlling the choroidal neovascularization may be important for retaining the best postoperative vision.
authors.forename: Motohiro
authors.initials: M
authors.lastname: Kamei
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Tano
mesh_terms: D004322:Drainage / Q000379:methods*; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005451:Fluorescein Angiography; D005500:Follow-Up Studies; D005654:Fundus Oculi; D006801:Humans; D007267:Injections; D007432:Intraoperative Period; D008266:Macula Lutea; D008297:Male; D008875:Middle Aged; D009887:Ophthalmoscopy; D012166:Retinal Hemorrhage / Q000473:pathology / Q000628:therapy*; D012189:Retrospective Studies; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome; D014792:Visual Acuity; D014821:Vitrectomy / Q000379:methods*; D014822:Vitreous Body
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator