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Y. Ozeki, N. Horio, A. Tanikawa, M. Horiguchi; Intravitreal Injection of Tissue Plasminogen Activator Reduces Macular Edema in Eyes With Central Retinal Vein Occlusion . Invest. Ophthalmol. Vis. Sci. 2005;46(13):4036.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To examine if tissue plasminogen activator (tPA) is effective to reduce macular edema and to improve visual acuity in eyes with central retinal vein occlusion (CRVO). Methods: Intravitreal injection of tPA was performed in 17 eyes of 17 patients with macular edema due to CRVO, and followed for more than 3 months. In 9 eyes (Group A), 325 µm/0.1 ml of tPA (monteplase), whose titer is equivalent to 70 microgram of alteplase, was injected into the vitreous cavity. In 8 eyes (Group B), 32.5 µm/0.1 ml of tPA was used. Visual acuity and foveal thickness determined by optical coherent tomography was measured preoperatively, at 1 week, 1 month, and 3 month after surgery. There were no differences in preoperative visual acuity, preoperative foveal thickness, type of ischemia, or follow–up period between the 2 groups. Results: The foveal thickness was significantly reduced in both eyes at 3 months after surgery (Group A: 634 ± 213 to 224 ± 104 µm, Group B: 777 ± 317 to 346 ± 195 µm) (P < 0.05). The improvement of visual acuity in log MAR unit was not different between the 2 groups (Group A: 0.26 ± 0.39, Group B: 0.60 ± 0.33). The visual acuity improved by 2 or more lines in 7 eyes of Group A, but reduced in 1 eye. In Group B, the visual acuity improved in 6 eyes, and did not change in 2 eyes. The visual acuity decreased at 1 week after surgery in 3 eyes of Group A and in 1 eye of Group B. Conclusions: Our results suggest that intravitreal injection of tPA may be effective to reduce macular edema, although the effect on visual outcome did not determined in this study. The lower doze of tPA may be safe and useful to treat macular edema in eyes with CRVO.
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