The Effect of Tissue Plasminogen Activator on Premacular Hemorrhage

ABSTRACT

Early vitrectomy is recommended for eyes with premacular hemorrhage, which facilitates fibrovascular proliferation and macular traction. To assess the effect of tissue plasminogen activator(tPA)on the absorption of premacular hemorrhage, we injected tPA(25 microgram)into the vitreous cavity of 13 eyes with premacular hemorrhage and followed for 30 days. We classified the type of hemorrhage according to the site of hemorrhage and the presence of posterior vitreous detachment(PVD). Four eyes had complete PVD following vitrectomy, 4 eyes had a hemorrhage in the subhyaloid space and 5 eyes had a hemorrhage in the subinternal limiting membrane. The mean absorption time of hemorrhage after tPA injection was 5. 5 days in 4 eyes of complete PVD and 12. 7 days in the remaining types. Visual acuity improved in 9 eyes, remained stable in 3 eyes and worsened in 1 eyes following tPA injection. Five eyes required pars plana vitrectomy due to recurrent vitreous hemorrhage and macular traction. TPA seemed to be considered another method of treatment in the eyes of premacular hemorrhage, especially in the vitrectomized eyes or eyes with complete PVD.