Skip to main content
NCBI home page
The British Journal of Ophthalmology logoLink to The British Journal of Ophthalmology
. 1996 Jul;80(7):658–662. doi: 10.1136/bjo.80.7.658

Fibrinolysis of experimental subretinal haemorrhage without removal using tissue plasminogen activator.

L S Morse 1, J D Benner 1, L M Hjelmeland 1, M B Landers 3rd 1
PMCID: PMC505564  PMID: 8795382

Abstract

AIMS/BACKGROUND: Human recombinant tissue plasminogen activator (rt-PA) fibrinolysis of subretinal haemorrhage with concomitant removal has been shown to reverse the natural history of photoreceptor degeneration in experimental subretinal haemorrhages if evacuated within 7 days. The aim of the study was to determine whether fibrinolysis of subretinal haemorrhage without concomitant removal would offer a simpler approach with similar photoreceptor sparing. METHODS: A neodymium YAG laser was used to create experimental subretinal haemorrhages beneath the holangiotic retina of the cat. Tissue plasminogen activator (10 micrograms/ml) was injected into 4 day old subretinal haemorrhages to evaluate its effect on altering the natural history of retinal degeneration. Light and electron microscopy were used to study the histopathological effect. RESULTS: The injection of rt-PA into large 4 day old subretinal haemorrhages without concomitant removal did not alter the natural history of retinal degeneration. In fact, a second focus of retinal degeneration occurred at a gravity dependent inferior site where the subretinal haemorrhages had migrated. CONCLUSIONS: There was no therapeutic benefit from the injection of rt-PA into subretinal haemorrhages without con-comitant removal in this cat model.

Full text

PDF
658

Images in this article

659Image
on p.659
659Image
on p.659
660Image
on p.660

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson D. H., Guérin C. J., Erickson P. A., Stern W. H., Fisher S. K. Morphological recovery in the reattached retina. Invest Ophthalmol Vis Sci. 1986 Feb;27(2):168–183. [PubMed] [Google Scholar]
  2. Benner J. D., Hay A., Landers M. B., 3rd, Hjelmeland L. M., Morse L. S. Fibrinolytic-assisted removal of experimental subretinal hemorrhage within seven days reduces outer retinal degeneration. Ophthalmology. 1994 Apr;101(4):672–681. doi: 10.1016/s0161-6420(94)31279-6. [DOI] [PubMed] [Google Scholar]
  3. Bennett S. R., Folk J. C., Blodi C. F., Klugman M. Factors prognostic of visual outcome in patients with subretinal hemorrhage. Am J Ophthalmol. 1990 Jan 15;109(1):33–37. doi: 10.1016/s0002-9394(14)75575-8. [DOI] [PubMed] [Google Scholar]
  4. Coll G. E., Sparrow J. R., Marinovic A., Chang S. Effect of intravitreal tissue plasminogen activator on experimental subretinal hemorrhage. Retina. 1995;15(4):319–326. doi: 10.1097/00006982-199515040-00009. [DOI] [PubMed] [Google Scholar]
  5. Dellaporta A. Retinal damage from subretinal hemorrhage. Am J Ophthalmol. 1983 Apr;95(4):568–570. doi: 10.1016/0002-9394(83)90294-5. [DOI] [PubMed] [Google Scholar]
  6. Flynn H. W., Jr, Davis J. L., Parel J. M., Lee W. G. Applications of a cannulated extrusion needle during vitreoretinal microsurgery. Retina. 1988;8(1):42–49. doi: 10.1097/00006982-198808010-00008. [DOI] [PubMed] [Google Scholar]
  7. Gillies A., Lahav M. Absorption of retinal and subretinal hemorrhages. Ann Ophthalmol. 1983 Nov;15(11):1068–1074. [PubMed] [Google Scholar]
  8. Han D. P., Mieler W. F., Schwartz D. M., Abrams G. W. Management of traumatic hemorrhagic retinal detachment with pars plana vitrectomy. Arch Ophthalmol. 1990 Sep;108(9):1281–1286. doi: 10.1001/archopht.1990.01070110097032. [DOI] [PubMed] [Google Scholar]
  9. Hanscom T. A., Diddie K. R. Early surgical drainage of macular subretinal hemorrhage. Arch Ophthalmol. 1987 Dec;105(12):1722–1723. doi: 10.1001/archopht.1987.01060120120037. [DOI] [PubMed] [Google Scholar]
  10. Ibanez H. E., Williams D. F., Thomas M. A., Ruby A. J., Meredith T. A., Boniuk I., Grand M. G. Surgical management of submacular hemorrhage. A series of 47 consecutive cases. Arch Ophthalmol. 1995 Jan;113(1):62–69. doi: 10.1001/archopht.1995.01100010064022. [DOI] [PubMed] [Google Scholar]
  11. Johnson M. W., Olsen K. R., Hernandez E. Tissue plasminogen activator thrombolysis during surgical evacuation of experimental subretinal hemorrhage. Ophthalmology. 1992 Apr;99(4):515–521. doi: 10.1016/s0161-6420(92)31939-6. [DOI] [PubMed] [Google Scholar]
  12. Johnson M. W., Olsen K. R., Hernandez E. Tissue plasminogen activator treatment of experimental subretinal hemorrhage. Retina. 1991;11(2):250–258. doi: 10.1097/00006982-199111020-00011. [DOI] [PubMed] [Google Scholar]
  13. Koshibu A. [Ultrastructural studies on absorption of an experimentally produced subretinal hemorrhage. III. Absorption of erythrocyte break down products and retinal hemosiderosis at the late stage (author's transl)]. Nippon Ganka Gakkai Zasshi. 1979 May 10;83(5):386–400. [PubMed] [Google Scholar]
  14. Lewis H. Intraoperative fibrinolysis of submacular hemorrhage with tissue plasminogen activator and surgical drainage. Am J Ophthalmol. 1994 Nov 15;118(5):559–568. doi: 10.1016/s0002-9394(14)76571-7. [DOI] [PubMed] [Google Scholar]
  15. Lewis H., Resnick S. C., Flannery J. G., Straatsma B. R. Tissue plasminogen activator treatment of experimental subretinal hemorrhage. Am J Ophthalmol. 1991 Feb 15;111(2):197–204. doi: 10.1016/s0002-9394(14)72259-7. [DOI] [PubMed] [Google Scholar]
  16. Thomas M. A., Halperin L. S. Subretinal endolaser treatment of a choroidal bleeding site. Am J Ophthalmol. 1990 Jun 15;109(6):742–744. doi: 10.1016/s0002-9394(14)72454-7. [DOI] [PubMed] [Google Scholar]
  17. Toth C. A., Benner J. D., Hjelmeland L. M., Landers M. B., 3rd, Morse L. S. Ultramicrosurgical removal of subretinal hemorrhage in cats. Am J Ophthalmol. 1992 Feb 15;113(2):175–182. doi: 10.1016/s0002-9394(14)71530-2. [DOI] [PubMed] [Google Scholar]
  18. Toth C. A., Morse L. S., Hjelmeland L. M., Landers M. B., 3rd Fibrin directs early retinal damage after experimental subretinal hemorrhage. Arch Ophthalmol. 1991 May;109(5):723–729. doi: 10.1001/archopht.1991.01080050139046. [DOI] [PubMed] [Google Scholar]
  19. Vander J. F., Federman J. L., Greven C., Slusher M. M., Gabel V. P. Surgical removal of massive subretinal hemorrhage associated with age-related macular degeneration. Ophthalmology. 1991 Jan;98(1):23–27. doi: 10.1016/s0161-6420(91)32348-0. [DOI] [PubMed] [Google Scholar]
  20. Wade E. C., Flynn H. W., Jr, Olsen K. R., Blumenkranz M. S., Nicholson D. H. Subretinal hemorrhage management by pars plana vitrectomy and internal drainage. Arch Ophthalmol. 1990 Jul;108(7):973–978. doi: 10.1001/archopht.1990.01070090075043. [DOI] [PubMed] [Google Scholar]

Articles from The British Journal of Ophthalmology are provided here courtesy of BMJ Publishing Group

RESOURCES