Fibrin Directs Early Retinal Damage after Experimental Subretinal Hemorrhage

Toth, CA; Morse, Lawrence S.; Hjelmeland, Leonard M.; Landers, Maurice B.

doi:10.1097/00006982-199212020-00018

Cited by 62 publications

(88 citation statements)

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“…29 Haemorrhage size and duration may serve as variables of prognostic importance after rTPA/gas. 27 In our study, we do not identify preoperative or intraoperative predictors of visual outcome. The small sample size and relative homogeneity of our series with regard to haemorrhage size (4-10 disc areas) resulted in limited power to detect differences in outcome on the basis of preoperative variables.…”

Section: Treatment Of Extensive Subfoveal Haemorrhage S Sacu Et Almentioning

confidence: 73%

“…As mentioned in some reports, reduced functional outcomes can be attributed to submacular haemorrhage and other effects, for example, iron toxicity, shearing forces, and blockage of oxygen distribution. 26,27 In a retrospective study, the treatment effect of intravitreal bevacizumab monotherapy was evaluated as treatment options for neovascular AMD with subretinal haemorrhage. 28 In contrast to our study, the authors also included eyes with a submacular haemorrhage not directly beneath the fovea.…”

Section: Treatment Of Extensive Subfoveal Haemorrhage S Sacu Et Almentioning

confidence: 99%

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Management of extensive subfoveal haemorrhage secondary to neovascular age-related macular degeneration

Sacu

Stifter

Vécsei-Marlovits

et al. 2008

Eye

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Section: Treatment Of Extensive Subfoveal Haemorrhage S Sacu Et Almentioning

confidence: 73%

Section: Treatment Of Extensive Subfoveal Haemorrhage S Sacu Et Almentioning

confidence: 99%

Management of extensive subfoveal haemorrhage secondary to neovascular age-related macular degeneration

Sacu

Stifter

Vécsei-Marlovits

et al. 2008

Eye

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“…[1][2][3][4] Shearing of photoreceptors by a fibrin clot, physical separation of photoreceptors from the retinal pigment epithelium, iron toxicity, and blockage of nutrient diffusion have been proposed as explanations for the retinal damage caused by thick subretinal blood. 5,6 The potential for vision loss has prompted investigation of safe and effective methods for removing thick blood beneath the macula, to speed visual recovery, and prevent irreversible blood-induced damage to the retina.…”

Section: Introductionmentioning

confidence: 99%

Effects of intravitreal gas with or without tissue plasminogen activator on submacular haemorrhage in age-related macular degeneration

et al. 2007

Eye

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Purpose To compare the anatomic and functional outcomes of treating thick submacular haemorrhage with intravitreal gas injection with and without tissue plasminogen activator (t-PA) in patients with age-related macular degeneration. Methods A review of age-related macular degeneration patients with submacular haemorrhage who underwent intravitreal gas injection with and without t-PA at a tertiary referral centre was conducted. Main outcome measures were best and final postoperative visual acuity. Results A total of 53 eyes of 53 patients were included, 28 eyes received intravitreal t-PA and gas injection (t-PA and gas group) and 25 eyes received intravitreal gas injection alone (gas-alone group). Incidence of best visual acuity improvement was significantly higher in the t-PA and gas group than in the gas-alone group (60.7 vs 32.0%; P ¼ 0.037). However, subgroup analysis demonstrated that the difference was significant only in eyes with haemorrhage duration of more than 14 days (46.2 vs 8.3%; P ¼ 0.035). Incidence of final visual acuity improvement was not significantly different between the two groups (42.9 vs 28.0%; P ¼ 0.39). The complications of vitreous haemorrhage and endophthalmitis were similar between the two groups. Multiple logistic regression analysis demonstrated that shorter haemorrhage duration (o14 days) was the main factor predictive of best visual acuity improvement (OR ¼ 9.02, P ¼ 0.015). Whether t-PA was used was of borderline significance (OR ¼ 4.96, P ¼ 0.046). AbstractConclusions Intravitreal t-PA was valuable for submacular haemorrhage only in eyes with relatively old haemorrhage. For eyes with recent onset of haemorrhage, t-PA is suggested only if initial gas injection failed to displace submacular haemorrhage.

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“…La presencia de sangre dentro de la retina es tóxi-ca para los fotorreceptores y el epitelio pigmentario (EPR) produciendo degradación de los mismos (2). La sangre subretiniana actúa de barrera impidiendo el intercambio metabólico entre los fotorreceptores y el EPR y la coroides (1,3), el alto contenido en hierro y la presencia de células inflamatorias en la sangre subretiniana, tante, la organización y retracción del coágulo con tracción retiniana (2) son los mecanismos a los que se atribuye el daño retiniano.…”

Section: Discussionunclassified

Hemorragia submacular traumatica tratada con rt-PA y SF6

Heras-Mulero

García-Gómez

Sádaba-Echarri

et al. 2007

Arch Soc Esp Oftalmol

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RESUMENCaso clínico: Paciente que presenta hemorragia submacular de origen traumático. Se realiza vitrectomía posterior y administración intravítrea de rt-PA y SF 6 . A las cuatro semanas la agudeza visual había pasado de 0,1 a 0,8. El paciente no presentó ninguna complicación derivada del tratamiento con rt-PA Discusión: Debido a que la sangre es tóxica para la retina esperar a su reabsorción espontánea comporta una pobre recuperación visual. El rt-PA administrado junto al SF 6 es útil para el tratamiento de hemorragias submaculares secundarias a degeneración macular asociada a la edad, pero también puede ser útil para la lisis de coágulos hemáticos traumáticos favoreciendo la recuperación de la agudeza visual.Palabras clave: rt-PA, hemorragia submacular, traumatismo ocular, activador tisular del plasminó-geno, sangre subfoveal. COMUNICACIÓN CORTA ABSTRACTCase report: This patient was afflicted by a traumatic submacular hemorrhage. A posterior vitrectomy was performed and intravitreal rt-PA and SF6 were administered. Four weeks later, the visual acuity had increased from 0.1 to 0.8. No complications due to the treatment with rt-PA were reported. Discussion: It is known that waiting for the spontaneous blood removal in such cases results in a poor visual acuity recovery due to a toxic effect of the blood products. Both rt-PA and the SF 6 are useful for the treatment of submacular hemorrhages secondary to age-related macular degeneration, and this case report has shown they are also useful to lyse traumatic blood clots, thus contributing to a better recovery of visual acuity (Arch Soc Esp Oftalmol 2007; 82: 517-520).

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Fibrin Directs Early Retinal Damage after Experimental Subretinal Hemorrhage

Cited by 62 publications

References 0 publications

Management of extensive subfoveal haemorrhage secondary to neovascular age-related macular degeneration

Management of extensive subfoveal haemorrhage secondary to neovascular age-related macular degeneration

Effects of intravitreal gas with or without tissue plasminogen activator on submacular haemorrhage in age-related macular degeneration

Hemorragia submacular traumatica tratada con rt-PA y SF6

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