June 2015
Volume 56, Issue 7
ARVO Annual Meeting Abstract  |   June 2015
Real-time intraoperative SD-OCT monitoring of transretinal rt-PA injection for AMD-related submacular hemorrhage
Author Affiliations & Notes
  • Pierre-Raphael Rothschild
    Ophthalmology, INSERM UMRS 872, Paris, France
    Ophthalmology, Hôpital Hotel Dieu, Paris, France
  • Sadri Chahed
    Hôpital Lariboisiere, Paris, France
  • Julien Perol
    Hôpital Lariboisiere, Paris, France
  • Maté Streho
    Hôpital Lariboisiere, Paris, France
  • Benedicte Marie Dupas
    Hôpital Lariboisiere, Paris, France
  • Salomon Y Cohen
    Hôpital Lariboisiere, Paris, France
  • Pascale G Massin
    Hôpital Lariboisiere, Paris, France
  • Alain Gaudric
    Hôpital Lariboisiere, Paris, France
  • Ramin Tadayoni
    Hôpital Lariboisiere, Paris, France
  • Footnotes
    Commercial Relationships Pierre-Raphael Rothschild, None; Sadri Chahed, None; Julien Perol, None; Maté Streho, None; Benedicte Dupas, None; Salomon Cohen, None; Pascale Massin, None; Alain Gaudric, None; Ramin Tadayoni, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2015, Vol.56, 2854. doi:https://doi.org/
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      Pierre-Raphael Rothschild, Sadri Chahed, Julien Perol, Maté Streho, Benedicte Marie Dupas, Salomon Y Cohen, Pascale G Massin, Alain Gaudric, Ramin Tadayoni; Real-time intraoperative SD-OCT monitoring of transretinal rt-PA injection for AMD-related submacular hemorrhage . Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):2854. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: To describe a minimally invasive technique for subretinal injection of Recombinant Tissue Plasminogen Activator (rt-PA).

Methods: Patients operated on for thick AMD-related submacular hemorrhage by transconjunctival 25-Gauge vitrectomy, transretinal injection of rt-PA through the 25G cannula with a 41G soft tip needle and fluid-gas exchange. Real-time monitoring of the infusion site to ascertain the absence of any retinal break was obtained by a microscope integrated SD-OCT system Postoperative prone positioning was advised for five days. Main outcome measures included hematoma displacement rate; pre- and postoperative best corrected visual acuity (BCVA) and postoperative complications.

Results: Nineteen patients were included. Mean age was 81,3 (±8.1) years and mean follow-up of 2.7 months. At postoperative month one, total displacement of the submacular hemorrhage was obtained for 11 patients (58%) and none had no displacement. Mean BCVA significantly improved from 2,1 (±0,9) to 1,6 (±0,8) LogMAR units (p=0.005). In all, 12 patients (70%) gained at least two lines of VA and only one patient lost two or more lines. Six patients (31%) had postoperative complications including intraocular bleeding (n=4); severe low IOP and rhegmatogenous retinal detachment.

Conclusions: Transretinal injection to treat AMD-related submacular hemorrhage seemed to be effective with acceptable risks as compared to more invasive procedures.


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