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Intravitreal recombinant tissue plasminogen activator, gas injection improve treatment of submacular hemorrhage
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Intravitreal recombinant tissue plasminogen activator improved best corrected visual acuity in patients with submacular hemorrhage associated with age-related macular degeneration when additional gas was injected the next day, a study found.
The retrospective, nonrandomized, comparative case study analyzed 110 eyes of 110 patients at baseline and at 1 to 3 weeks, 3 months and 6 months after treatment.
Patients were divided into groups based on recombinant tissue plasminogen activator dosage (50 μg, 100 μg or 200 μg) and whether they received an additional gas injection. The best results were found in those who received 50 μg or 100 μg of intravitreal recombinant tissue plasminogen activator followed by pneumatic displacement with gas the subsequent day. Better improvements were observed in patients who were younger and had a smaller hemorrhage size and a shorter duration of hemorrhage onset.
Complications were reported in 13.6% of patients.
Larger prospective studies are needed to determine the minimum toxic threshold and the best therapeutic dosage of recombinant tissue plasminogen activator for treating subretinal hemorrhages, the study authors said.
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