Tissue Plasminogen Activator in Treatment of Submacular Hemorrhage

Abstract

Abstract: : Purpose: We investigated the use of intravitreal tPA (tissue plasminogen activator) to clear submacular hemorrhage. Methods: 20 consecutive patients were evaluated Retrospectively. The causes for submacular haemorrhage included age related macular degeneration (ARMD) (3 cases),idiopathic polypoidal choroidal vasculopathy (IPCV)(15 cases), and trauma (1 case) and macroaneurysm (1 case). All cases underwent intravitreal injection of tPA and perfluoropropane by a single surgeon with prone positioning post operatively to displace submacular blood. Results: Submacular blood was successful displaced in all cases. 50% achieved 6/12 vision or better. Treatment within 2 weeks of symptoms was associated with better visual outcome. Complications included retinal detachment (3 cases)and glaucoma requiring treatment (1 case). Conclusion: tPA is useful in treating submacular haemorrhage. Visual outcome is better when the procedure is performed within 2 weeks of the submacular haemorrhage.

Keywords: 554 retina