title: Comparison of pneumatic displacement for submacular hemorrhages with gas alone and gas plus tissue plasminogen activator.
abstract: OBJECTIVE
  To retrospectively evaluate efficacy, safety, and visual outcomes of pneumatic displacement for submacular hemorrhages (SMHs) with or without tissue plasminogen activator (tPA).
  
  
  METHODS
  Sixty-eight eyes with fresh SMHs underwent pneumatic displacement. Thirty eyes received intravitreal injection of pure C3F8 gas alone and 38 eyes received gas with tPA (25 μg). The visual analog scale was used to evaluate displacement. The main outcome measures were the visual analog scale score and best-corrected visual acuity 1 month after treatment. The efficacy and safety of tPA were evaluated.
  
  
  RESULTS
  The visual analog scale score was 4.9 ± 2.5 in the gas group and 5.9 ± 2.9 in the gas plus tPA group. Sixteen eyes (53.3%) in the gas group and 15 eyes (39.5%) in the gas plus tPA group had best-corrected visual acuity improvements. In the gas group, complications included retinal detachment (n = 1, 3.3%), vitreous opacity (n = 7, 23.3%), and rebleeding (n = 1, 3.3%). In the gas plus tPA group, vitreous opacity (n = 6, 15.8%) was the only complication. Overall, both groups had similar displacement of SMH, visual improvement, and complication rates at 1 month.
  
  
  CONCLUSIONS
  Intravitreal injection of pure C3F8 gas displaced SMHs and improved best-corrected visual acuity in eyes with SMHs. No adjuvant effect or adverse reactions of tPA were found.
authors.affiliation: *Department of Ophthalmology, Shiga University of Medical Science, Otsu, Japan; and †Department of Ophthalmology, Osaka University, Suita, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Fujikawa
authors.forename: Osamu
authors.initials: O
authors.lastname: Sawada
authors.forename: Taichiro
authors.initials: T
authors.lastname: Miyake
authors.forename: Masashi
authors.initials: M
authors.lastname: Kakinoki
authors.forename: Tomoko
authors.initials: T
authors.lastname: Sawada
authors.forename: Hajime
authors.initials: H
authors.lastname: Kawamura
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Sakaguchi
authors.forename: Fumi
authors.initials: F
authors.lastname: Gomi
authors.forename: Masahito
authors.initials: M
authors.lastname: Ohji
mesh_terms: D000368:Aged; D003131:Combined Modality Therapy; D058450:Endotamponade; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005466:Fluorocarbons / Q000008:administration & dosage*; D006801:Humans; D058449:Intravitreal Injections; D008297:Male; D011312:Pressure; D012166:Retinal Hemorrhage / Q000503:physiopathology / Q000628:therapy*; D012189:Retrospective Studies; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome; D014792:Visual Acuity / Q000502:physiology; D064232:Visual Analog Scale
chemical_list: D005343:Fibrinolytic Agents; D005466:Fluorocarbons; C042852:perflutren; D010959:Tissue Plasminogen Activator