INTRAVITREAL INJECTION OF TISSUE PLASMINOGEN ACTIVATOR AND GAS IN SUBRETINAL HEMORRHAGE CAUSED BY AGE-RELATED MACULAR DEGENERATION


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Abstract

Purpose:To assess the efficacy and safety of intravitreal injection of recombinant tissue plasminogen activator and sulfur hexaflucride gas for displacement of subretinal hemorrhages in patients with age-related macular degeneration.Methods:The authors injected 25 μg of recombinant tissue plasminogen activator and 0.5 mL sulfur hexafluoride gas intravitreally in 11 patients with subretinal hemorrhages of less than 3 weeks duration. Anatomic and functional results were evaluated.Results:Displacement of subretinal blood was successful within the first week after surgery in 10 of 11 patients. This was accompanied by visual improvement in eight patients. After 1 year, visual acuity was better than before surgery in five patients. Diagnosis of a choroidal neovascularization by fluorescein angiography was possible in all patients, and was treated with laser photocoagulation in five. The authors observed no adverse effects of treatment.Conclusion:Recombinant tissue plasminogen activator and gas effectively displace subretinal blood in patients with age-related macular degeneration. Randomized studies are necessary to prove the benefit of this simple and safe method in patients with subretinal hemorrhage due to age-related macular degeneration.

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