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Clinical Ophthalmology (Auckland, N.Z.) logoLink to Clinical Ophthalmology (Auckland, N.Z.)
letter
. 2012 Jan 19;6:145. doi: 10.2147/OPTH.S28071

Tissue plasminogen activator (tPA) in the management of predominantly hemorrhagic age-related macular degeneration, milligram/milliliter or microgram/milliliter?

Niels Willem Boone 1,, Roelof Wouter Frederik van Leeuwen 1
PMCID: PMC3267534  PMID: 22291455

Recently our hospital pharmacy, which serves an academic hospital with an internationally well-known department of ophthalmology, received a request for the aseptic preparation of an alteplase syringe solution for subretinal administration. Looking for dose rationale, our ophthalmology doctor came up with a concentration based on an article published by Arias and colleagues in Clinical Ophthalmology in 2010.1 This article is on subretinal alteplase administration for hemorrhagic age-related macular degeneration. In the methods section, a concentration of 125 mg/mL alteplase was declared, which we found peculiar. This concentration cannot be acquired with the commercially available preparation (which has a maximum concentration of 2 mg/mL), and could lead to undesirable side effects. In the literature, it is stated that an alteplase dose should be in the range of 200 μg/mL.2 Did the authors mean 125 μg/mL?

Footnotes

Disclosure

The authors declare no conflicts of interest in this work.

References

  • 1.Arias L, Monés J. Transconjunctival sutureless vitrectomy with tissue plasminogen activator, gas and intravitreal bevacizumab in the management of predominantly hemorrhagic age-related macular degeneration. Clin Ophthalmol. 2010;18(4):67–72. doi: 10.2147/opth.s8635. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 2.Treumer F, Klatt C, Roider J, Hillenkamp J. Subretinal coapplication of recombinant tissue plasminogen activator and bevacizumab for neovascular age-related macular degeneration with submacular haemorrhage. Br J Ophthalmol. 2010;94(1):48–53. doi: 10.1136/bjo.2009.164707. [DOI] [PubMed] [Google Scholar]

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