Intravitreal Versus Subretinal Tissue Plasminogen Activator Injection for Submacular Hemorrhage

Ophthalmic Surg Lasers Imaging Retina. 2017 Jan 1;48(1):26-32. doi: 10.3928/23258160-20161219-04.

Abstract

Background and objective: The objective of this study was to compare visual acuity outcomes between the following procedures used to treat submacular hemorrhages: pneumatic displacement followed by intravitreal tissue plasminogen activator (tPA) if needed (pneumatic ± tPA) and pars plana vitrectomy (PPV) with subretinal tPA (PPV + tPA).

Patients and methods: This is a retrospective chart review of submacular hemorrhages treated with either pneumatic ± tPA or PPV + tPA.

Results: Eighteen patients had pneumatic ± tPA, and 14 patients had PPV + tPA. The percentage of patients achieving three lines or greater of vision improvement 1 year postoperatively was 46% and 18% in these groups, respectively (P = .194).

Conclusion: The difference in visual acuity was not statistically significant; however, the lack of a statistical difference is important as pneumatic ± tPA is a less-invasive, less costly procedure that can be done in a clinical setting. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:26-32.].

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Female
  • Follow-Up Studies
  • Humans
  • Injections
  • Intravitreal Injections
  • Macula Lutea / pathology
  • Male
  • Retina
  • Retinal Hemorrhage / diagnosis
  • Retinal Hemorrhage / drug therapy*
  • Retrospective Studies
  • Tissue Plasminogen Activator / administration & dosage*
  • Tomography, Optical Coherence
  • Treatment Outcome
  • Visual Acuity*

Substances

  • Tissue Plasminogen Activator