Abstract
Abstract: :
Purpose: To evaluate the safety and the efficacy of extravascular in situ thrombolytic application (r-TPA) for the management of central and branch retinal vein thrombosis. Methods: Five patients, 3 males and 2 females, 3 with CVO and 2 BVOs, 66 to 80 years old, were operated between May and Nov 2002. The technique included three port vitrectomy with posterior vitreous detachment, fluid-air exchange, and finally infusion of 50 µg r-TPA in 0.5 ml water for injection solution. All patients were advised for supine position for 6 hours after surgery. Results: The follow-up period after surgery ranged from 1 to 6 months (mean: 3.6 months). Visual acuity remained stable in 3 patients and improved in the rest. Intraretinal hemorrhages and edema improved in all patients. One patient presented faint intravitreal hemorrhage that resolved spontaneously during the first postoperative month. Conclusions: This novel approach seems to be safe and promising for the management of retinal vein thrombosis. More patients and longer follow-up are necessary for the evaluation of the clinical results of the technique.
Keywords: vascular occlusion/vascular occlusive disease • retina • vitreoretinal surgery