title: Vitreous hemorrhage complicating intravitreal tissue plasminogen activator and pneumatic displacement of submacular hemorrhage.
abstract: OBJECTIVE
  To evaluate the clinical factors associated with vitreous hemorrhage (VH) complicating intravitreal tissue plasminogen activator and pneumatic displacement of submacular hemorrhage, and analyze visual outcomes.
  
  
  METHODS
  In this retrospective, comparative study, 120 consecutive eyes underwent intravitreal tissue plasminogen activator (50 μg) and perfluoropropane (0.3 mL) injection for submacular hemorrhage secondary to different causes. We recorded their demographic data, visual acuity, complications, and further treatment after VH. Two groups created according to the occurrence of VH were compared to identify possible risk factors.
  
  
  RESULTS
  Breakthrough VH occurred in 18 eyes (15%). The size of submacular hemorrhage was significantly positively related to the occurrence of VH (P for trend <0.001). Among etiology, idiopathic polypoidal choroidal vasculopathy (IPCV) was associated with a significantly higher incidence of VH (odds ratio, 15.63; 95% confidence interval, 2.30-106.15; P = 0.005). Age-related macular degeneration was much less likely than other causes to result in VH (odds ratio, 0.121; 95% confidence interval, 0.023-0.642; P = 0.013). Best and final visual acuity improved significantly from initial visual acuity in both groups (P < 0.05).
  
  
  CONCLUSIONS
  A large area of submacular hemorrhage (≥10 disk areas) and IPCV were risk factors for VH after injection. The occurrence of VH did not affect final visual outcome.
authors.affiliation: Department of Ophthalmology, Kaohsiung Veterans General Hospital, Kaohsiung, Republic of China.
authors.forename: Tsung-Tien
authors.initials: TT
authors.lastname: Wu
authors.forename: Ya-Hsin
authors.initials: YH
authors.lastname: Kung
authors.forename: May-Ching
authors.initials: MC
authors.lastname: Hong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D005451:Fluorescein Angiography; D005466:Fluorocarbons / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007208:Indocyanine Green; D007429:Intraocular Pressure / Q000502:physiology; D058449:Intravitreal Injections; D008297:Male; D008875:Middle Aged; D012166:Retinal Hemorrhage / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D012189:Retrospective Studies; D012307:Risk Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage / Q000009:adverse effects*; D014792:Visual Acuity / Q000502:physiology; D014821:Vitrectomy; D014823:Vitreous Hemorrhage / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery; D055815:Young Adult
chemical_list: D005343:Fibrinolytic Agents; D005466:Fluorocarbons; C042852:perflutren; D010959:Tissue Plasminogen Activator; D007208:Indocyanine Green