Retinal pigment epithelial tear after subretinal rtpa and intravitreal air for the displacement of a large submacular hemorrhage.
OBJECTIVE
The authors report a case of retinal pigment epithelial (RPE) tear following pars plana vitrectomy (PPV), subretinal recombinant tissue plasminogen activator (rt-PA), and intravitreal gas administration for the displacement of large submacular hemorrhage.


METHODS
A patient with a large submacular hemorrhage secondary to neovascular age-related macular degeneration (AMD) received a subretinal rt-PA injection and intravitreal air installation after PPV. Ophthalmic examination included standardized visual acuity testing and fluorescein angiography.


METHODS
One patient from the authors' outpatient clinic.


RESULTS
Baseline visual acuity of the eye was 20/160. Ophthalmoscopy showed a predominantly hemorrhagic lesion in the macula. Ophthalmoscopy and fluorescein angiography 2 weeks after the surgery revealed a RPE tear. Postoperative visual acuity was 20/1000.


CONCLUSIONS
This case demonstrates that a RPE tear is a possible complication of the procedure of subretinal rt-PA and intravitreal air tamponade after PPV for the displacement of a large submacular hemorrhage secondary to neovascular AMD. The surgeon has to be aware about this complication and should inform the patient before surgery.
From the Center for Ophthalmology, University of Tuebingen, Germany.
Sabine
S
Biester
Karl U
KU
Bartz-Schmidt
Faik
F
Gelisken