Intravitreal Versus Subretinal Tissue Plasminogen Activator Injection for Submacular Hemorrhage

• Published in: Ophthalmic surgery, lasers & imaging Vol. 48; no. 1; pp. 26 - 32
• Main Authors: Bell, James E, Shulman, Julia P, Swan, Russell J, Teske, Michael P, Bernstein, Paul S
• Format: Journal Article
• Language: English
• Published: United States SLACK INCORPORATED 01.01.2017
• Subjects: Aged; Eye diseases; Eye surgery; Female; Follow-Up Studies; Hemorrhage; Humans; Injections; Intravitreal Injections; Macula Lutea - pathology; Male; Retina; Retinal Hemorrhage - diagnosis; Retinal Hemorrhage - drug therapy; Retrospective Studies; Surgical outcomes; Tissue Plasminogen Activator - administration & dosage; Tomography, Optical Coherence; Treatment Outcome; Visual Acuity
• ISSN: 2325-8160; 2325-8179
• DOI: 10.3928/23258160-20161219-04

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). This is a retrospective chart review of submacular hemorrhages treated with either pneumatic ± tPA or PPV + tPA. 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). 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.].