A new treatment method for hemorrhagic retinal detachment by drainage sclerotomy combined with subretinal and submacular injections of tPA

Author: Yong Wei (China)

Co-authors:

Purpose

To evaluate the effect of a new drainage sclerotomy method combined with subretinal and submacular injections of recombinant tissue plasminogen activator (tPA) in treatment of hemorrhagic retinal detachment (RD).

Setting/Venue

case-series report

Methods

Eight eyes underwent vitrectomy combined with the evacuation of subretinal hemorrhage from the site of the sclerotomy. Among them, 2 eyes received subretinal injections of tPA, 3 eyes received intraoperative submacular injection of tPA, and the other 3 eyes received both subretinal and submacular injections of tPA. The regression of subfoveal hemorrhage was monitored after operation.

Results

The submacular hemorrhages and the most of the subretinal hemorrhages were removed successfully in all eyes. The subfoveal hemorrhage was resolved between 1 day to 1 month postoperatively in the eyes with either subretinal injection or submacular injection or both. There was no vitreous or anterior chamber hemorrhage or elevated intraocular pressure observed after operation.

Conlusions

Our results suggest that the external drainage of subretinal hemorrhages from the site of sclerotomy combined with subretinal and submacular injections of tPA, was an effective and safe therapeutic strategy for treating hemorrhagic RD.