title: Intrasurgical assessment of subretinal tPA injection for submacular hemorrhage in the PIONEER study utilizing intraoperative OCT.
abstract: OBJECTIVE
  To assess the feasibility of intraoperative OCT (iOCT) during pars plana vitrectomy with subretinal tissue plasminogen activator (tPA) injection for subretinal hemorrhage.
  
  
  METHODS
  Eyes that underwent vitrectomy and subretinal injection of tPA were identified from the PIONEER study, a prospective clinical study assessing the feasibility and utility of iOCT in ophthalmic surgery. A microscope-mounted spectral-domain OCT system was utilized for iOCT imaging. Standardized scan protocol and image acquisition were followed for intraoperative imaging.
  
  
  RESULTS
  iOCT was successfully obtained in four of four eyes. In all cases, increased subretinal fluid was noted, with differential reflectivity visualized between the hemorrhage-tPA interface confirming appropriate localization of tPA injection. Image quality variability was significant.
  
  
  CONCLUSIONS
  iOCT can successfully be performed during pars plana vitrectomy with subretinal tPA injection. Utilizing iOCT, appropriate placement of tPA solution and corresponding retinal architectural changes were visualized.
authors: Justis P
authors: JP
authors: Ehlers
authors: Daniel S
authors: DS
authors: Petkovsek
authors: Alex
authors: A
authors: Yuan
authors: Rishi P
authors: RP
authors: Singh
authors: Sunil K
authors: SK
authors: Srivastava
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058450:Endotamponade; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D056965:Injections, Intraocular; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011187:Posture; D011446:Prospective Studies; D012166:Retinal Hemorrhage / Q000175:diagnosis / Q000188:drug therapy*; D013459:Sulfur Hexafluoride / Q000008:administration & dosage; D025321:Surgery, Computer-Assisted; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D041623:Tomography, Optical Coherence / Q000379:methods; D014792:Visual Acuity; D014821:Vitrectomy
chemical_list: D005343:Fibrinolytic Agents; D010959:Tissue Plasminogen Activator; D013459:Sulfur Hexafluoride