gms | German Medical Science

104th DOG Annual Meeting

21. - 24.09.2006, Berlin

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Surgery of submacular hemorrhage with the combination of tissue plasminogen activator – a case report

Meeting Abstract

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  • V. Korda - Department of Ophthalmology, Charles University Prague, Medical Fakulty in Hradec Kralove, Hradec Kralove, Czech Republic
  • Z. Dubravska - Department of Ophthalmology, Charles University Prague, Medical Fakulty in Hradec Kralove, Hradec Kralove, Czech Republic
  • D. Hejcmanova - Department of Ophthalmology, Charles University Prague, Medical Fakulty in Hradec Kralove, Hradec Kralove, Czech Republic
  • P. Rozsival - Department of Ophthalmology, Charles University Prague, Medical Fakulty in Hradec Kralove, Hradec Kralove, Czech Republic

Deutsche Ophthalmologische Gesellschaft e.V.. 104. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft (DOG). Berlin, 21.-24.09.2006. Düsseldorf, Köln: German Medical Science; 2006. Doc06dogP045

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dog2006/06dog567.shtml

Published: September 18, 2006

© 2006 Korda et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

To assess the effectiveness of subretinal injection of recombinant tissue plasminogen activator (rTPA) and gas on submacular hemorrhage by patient with trauma of eye with choroidal rupture.

Methods

In this case we present study of 22 years old man with blunt trauma of right eye. The patient underwent a complete vitrectomy with removal of posterior hyaloid. Following a small retinotomy, 10µg/0,1 ml of recombinant TPA was injected into the submacular clot. After a waiting period ranging from 20-30 minutes, the hemorrhage was drained with a single 30-gauge subretinal cannula through the retinotomy site. A complete gas-fluid exchange was then performed with the aspirating tip over retinotomy site to remove any residual subretinal blood. The retinotomy site was treated with endophotocoagulation and a nonexpansile concentration of SF6 was infused. Prone position was instituted throughout the firtst postoperative week. Lysis of subretinal blood was assessed ophthalmoscopically and visual function was evaluated on Snellen and ETDRS optotypes.

Results

Befor operation BCVA was light perception and hand motions, 6 months postoperatively mean visual acuity 6/60, ophthalmoscopically in macula subretinally scarring band from choroidal ruptura.

Conclusions

Submacular hemorrhage primary to choroidal ruptura has a good visual prognosis.The addition of tissue plasminogen activator-assisted clot lysis does appear to improve the visual outcome following surgery.