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The Effect of Tissue Plasminogen Activator on Retinal Bleeding
Paul Sternberg, Jr, MD;
Hilda E. Aguilar, MD;
Carolyn Drews, PhD;
Thomas M. Aaberg, MD
Arch Ophthalmol. 1990;108(5):720-722.
Abstract
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• Tissue plasminogen activator is a potent thrombolytic agent that recently has been used to treat postvitrectomy fibrin formation. However, a recent report noted anterior and posterior segment bleeding following intracameral tissue plasminogen activator injection. In this study, we performed lensectomy and vitrectomy in 20 rabbits. A retinal blood vessel was incised to stimulate intraocular hemorrhage; bleeding was controlled and vitreous hemorrhage aspirated. Postoperatively, one eye received a 0.1-mL injection of tissue plasminogen activator (25 µg); the other received balanced salt solution. The eyes receiving tissue plasminogen activator had a 28% incidence of increased anterior chamber blood and a 61% incidence of increased intravitreal blood. There was no evidence of postinjection bleeding in eyes receiving balanced salt solution. Most cases of bleeding occurred within 24 hours of tissue plasminogen activator injection. Administration of tissue plasminogen activator in the setting of segmented blood vessels may lead to intraocular hemorrhage.
Author Affiliations
From the Departments of Ophthalmology (Drs Sternberg, Aguilar, Drews, and Aaberg) and Epidemiology and Biostatistics (Dr Drews), Emory University School of Medicine, Atlanta, Ga.
Footnotes
Accepted for publication January 2, 1990.
Reprint requests to Department of Ophthalmology, Emory University School of Medicine, 1327 Clifton Rd NE, Atlanta, GA 30322 (Dr Sternberg).
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ABSTRACT
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