#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

The Intravitreal Application of the Tissue Plasminogen Activator in the Treatment of Submacular Hemorrhage – A Case Report


Authors: E. Fric 1;  M. Šín 1;  M. Rehák 1,2;  O. Chrapek 1;  J. Šimičák 1;  J. Řehák 1
Authors‘ workplace: Oční klinika FN a UP Olomouc 1;  Klinik und Poliklinik für Augenheilkunde, Universität Leipzig 2
Published in: Čes. a slov. Oftal., 64, 2008, No. 6, p. 237-240

Overview

The authors present the possibility to influence therapeutically the submacular hemorrhage caused by age-related macular degeneration in the presence of choroidal neovascular membrane by means of recombinant plasminogen tissue activator (rt- PA) and expansive gas intravitreal injection followed by pneumatic relocation of the hemorrhage out of the foveolar region. The therapy is presented in a case report. The submacular hemorrhage without treatment causes serious decrease of visual functions. The human recombinant plasminogen tissue activator that is a glycoprotein, activating the transformation of plasminogen directly to plasmin has a trombolytic effect. Rt-PA is activated by binding to fibrin with high affinity. This minimally invasive procedure gives the possibility to treat this prognostic unfavorable finding, so after the lysis and pneumorelocation of the hemorrhage from the macular region we can treat the choroidal neovascular membrane.

Key words:
Age-related macular degeneration, submacular hemorrhage, intravitreal injection, recombinant plasminogen tissue activator, choroidal neovascular membrane


Sources

1. Avery, R.L., Fekrat, S.,Hawkins, B.S. et al.: Natural history of subfoveal subretinal hemorrhage in age-related macular degeneration. Retina, 16, 1996: 183–189.

2. Bennett, S., Folk, S., Blodi, C., et al.: Factor prognostic of visual outcome in patients with subretinal hemorrhage. Am J Ophthalmol.,16, 1996: 33–37.

3. Boone, D.E., Boldt, H.C., Ross, R.D. et al.: The use of intravitreal tissue plasminogen activator on experimental hemorrhage in pig model. Retina, 16, 1996: 518–524.

4. Coll, G.E., Sparrow, J.R.,Marinovic, A. et al.: Effect of intravitreal tissue plasminogen activator in treatment of experimental subretinal hemorrhage, Retina, 15: 319–326.

5. De Juan, E. Machemar, R.: Vitreous surgery for hemorrhagic and fibrous complication of age-related macular degeneration. Am. J. Ophtalmol., 105, 1988: 25–29.

6. Glatt, H., Marcher, R.: Experimental subretinal hemorrhage in rabbits. Am J Ophthalmol., 94, 1982: 762–773.

7. Hanscom, T.A. Diddie, K.R.: Early surgical drainage of macular subretinal hemorrhage. Arch. Ophtalmol., 105, 1987: 1722–1723.

8. Hassan, A.S., Johnson, M.W., Schneiderman, T.E. et al.: Management of submacular hemorrhage with intravitreous tissue plasminogen activator injection and pneumatic displacement. Ophthalmology, 106, 19996: 1900–1907.

9. Hattenbach, L.O., Klais, C., Koch, F.H. et al.: Intravitreal injection of tissue plasminogen activator and gas in the treatment of submacular hemorrhage under various conditions. Ophthalmology, 108, 2001: 1485–1492.

10. Hesse, L., Schmidt, J., Kroll, P. et al.: Management of acute submacular hemorrhage using recombinant tissue plasminogen activator and gas. Graefes Arch. Clin. Exp. Ophthal., 237,1999: 273–277.

11. Chen, C.Y., Hooper C., Chiu, D. et al.: Management of subretinal hemorrhage with intravitreal injection of tissue plasminogen activator and expansive gas. Retina, 27, 2007: 321–328.

12. Chen, W.L., Liu, J.H., Lee, F.L.: Natural course of subfoveal hemorrhage, Chinese Med. J., 62, 1999: 268–277.

13. Kamei, M., Misono, K., Lewis, H.: A study of the ability of tissue plasminogen activator to diffuse into the subretinal space after intravitreal injection in rabbits. ., 128, 1999: 739–46.

14. Kamei, M., Tano, Y., Maeno, T. et al.: Surgical removal of submacular hemorrhage using tissue plasminogen activator and perfluorocarbon liquid. Am J Ophthalmol., 121, 1996: 267–275.

15. Kimura, A.E, Reddy, C.V., Folk, J.C. et al.: Removal of subretinal hemorrhage facilitated by perioperative intravitreal tissue plasminogen activator. Retina, 14, 1994: 83–84.

16. Korda, V., Dúbravská, Z., Hejcmanová, D. et al.: Chirurgické řešení submakulární hemoragie v kombinaci s tkáňovým aktivátorem plazminogenu (kazuistické sdělení). Čes. a slov. Oftal., 62, 2006, 4: 275–279.

17. Kreiger, A.E., Haidit, S.: Vitreal hemorrhage in senile macular degeneration. Retina, 3, 1983: 318–321.

18. Krepler, K., Krater, A., Tittl, M. et al.: An intravitreal injection of tissue plasminogen activator and gas in subretinal hemorrhage caused by age – related macular degeneration. Retina, 20, 2000: 251–256.

19. Kwan, S., Vijayasekaran, S., McAllister, I. et al.: A study of retinal penetration of intravitreal tenecteplase in pig, Investment Ophthalmol Vis Sci., 46, 2006: 2662–2667.

20. Lewis, H.: Intraoperative fibrinolysis of submacular hemorrhage with tissue plasminogen activator and surgical drainage, Am J Ophthalmol., 118, 1994: 559–568.

21. Lewis, H., Resnick, S.C., Flandery, J.G. et al.: Tissue plasminogen activator treatment of experimental subretinal hemorrhage, Am J Ophthalmol., 111, 1991: 197–204.

22. Marmor, M., Negi, A., Maurice, D.: Kinetics of macromolecule injected into the subretinal space, Exp Eye Res., 40, 1985: 687–696.

23. Ohji, M., Saito, Y., Haydashi, A.: Pneumatic displacement of subretinal hemorrhage without tissue plasminogen activator. Arch Ophthalmol., 116, 1998: 1326–1332.

24. Peyman, G.A., Nelson, N.G. Jr., Alturki, W. et al.: Tissue plasminogen activating assisted removal of subretinal hemorrhage. Ophthalmic Surg., 22, 1991: 575–582.

25. Sawa, M.M., Ober, M.D.M., Spaide, R.F.M.: Autofluorescence and retinal pigment epithelial atrophy after subretinal hemorrhage. Retina, 26, 2006: 119–120.

26. Schulze, S.D., Hesle, L.: Tissue plasminogen activator plus gas injection in patiens with subretinal hemorrhage cause by age – related macular degeneration: predictive variables for visual outcome. Graefes Arch Clin Exp Ophthal, 240, 2002: 717–720.

27. Submacular surgery trials research. Surgery for subfoveolar choroideal neovascularisation in age – related macular degeneration: Ophthalmic findings: SST report No 11, Ophthalmology, 111, 204: 1967.

28. Takeuchi, A., Kricorian, G., Yao, X. et al.: The rate and source of albumin entry into saline filled experimental retinal detachment. Invest Ophthalmol Vis Sci., 35, 1994: 3792–3798.

29. Verstraaten, T.C., Chapman, C., Hartzer, M. et al.: Pharmacologic induction of posterior vitreous detachment in the rabbit. Arch Ophthalmol., 111, 1993: 849–854.

30. Wade, E.C., Flynn, H.W., Olsen, K.R.E.: Subretinal hemorrhage management by pars plana vitrectomy and internal drainage. Arch Ophthalmol., 108, 1990: 973–978.

Labels
Ophthalmology
Topics Journals
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#