Recombinant tissue plasminogen activator in the treatment of suprachoroidal hemorrhage
Nancy Kunjukunju1, Christine R Gonzales2, William S Rodden21Ochsner Medical Center, New Orleans, Louisiana; 2Retina and Vitreous Center of Southern Oregon, Ashland, Oregon, USABackground: Suprachoroidal hemorrhages are a vision-threatening complication, and poor visual outcome is correlated with inc...
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| Autores principales: | , , |
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| Formato: | article |
| Lenguaje: | EN |
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Dove Medical Press
2011
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| Acceso en línea: | https://doaj.org/article/7fd2b113c69b43aaba4c9d89964f8ea3 |
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| Sumario: | Nancy Kunjukunju1, Christine R Gonzales2, William S Rodden21Ochsner Medical Center, New Orleans, Louisiana; 2Retina and Vitreous Center of Southern Oregon, Ashland, Oregon, USABackground: Suprachoroidal hemorrhages are a vision-threatening complication, and poor visual outcome is correlated with increasing hemorrhage complexity. The recommended time of surgical drainage is 10–14 days after the hemorrhage begins to liquefy. We describe a case in which recombinant tissue plasminogen activator (r-tPA), alteplase, is injected within the suprachoroidal space before surgery to assist in the drainage of an organized clot prior to liquefaction. This is a report of a technique in which r-tPA is used in the intrachoroidal space to target the organized clot of suprachoroidal hemorrhage prior to drainage.Case report: A 62-year-old male presented 12 days after retinal detachment repair with sudden ocular pain and vision loss after a Valsalva maneuver. Vision was light perception only, and intraocular pressure was 43 mmHg. Diagnosed with hyphema and suprachoroidal hemorrhage, the patient underwent surgery the following day. An injection of r-tPA 100 µg was given intracamerally, and an additional dose of r-tPA 100 µg was injected into the suprachoroidal space prior to surgery. Liquified by r-tPA, the clot was expressed through the sclerotomies. Best corrected vision in the eye eight months after the drainage procedure was 20/40.Conclusion: To the author’s knowledge, this is the first reported case in which r-tPA was successfully injected in the suprachoroidal space to liquefy and drain a suprachoroidal hemorrhage prior to natural dissolution.Keywords: tPA, suprachoroidal hemorrhage, vision loss |
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