2000
DOI: 10.1001/archopht.118.5.659
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Retinal Toxicity of Commercial Intravitreal Tissue Plasminogen Activator Solution in Cat Eyes

Abstract: Background: We previously reported retinal toxic reactions in rabbit eyes receiving intravitreal injections of commercial tissue plasminogen activator (tPA) in concentrations greater than or equal to 50 µg/0.1 mL, and recent clinical experience suggests that intravitreal tPA solution may produce toxic effects in human eyes. We therefore investigated the dose-dependent retinal toxicity of intravitreal commercial recombinant tPA solution in cat eyes, which have a vascularized inner retina and vitreous volume sim… Show more

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Cited by 72 publications
(51 citation statements)
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“…Both reduced SDS-PAGE analysis and chromogenic substrate S-2251 confirmed more than 80% activation of mPlg by 0.5% molar ratio of rt-PA at 40 min. Our highest rt-PA dosage, 0.5mg/0.1 ml, was far below the values reported by Le Mer et al 23 and Hrach et al, 26 who observed clinical, electrophysiologic, and histological alterations in cat eyes receiving intravitreal rt-PA doses greater than or equal to 50 mg. Our histologic examinations confirmed the safety of very low dose of rt-PA. There was no difference in the retinal anatomy between mPlm-treated eyes and control eyes.…”
Section: Enzymatic Vitreolysis W Chen Et Alcontrasting
confidence: 60%
“…Both reduced SDS-PAGE analysis and chromogenic substrate S-2251 confirmed more than 80% activation of mPlg by 0.5% molar ratio of rt-PA at 40 min. Our highest rt-PA dosage, 0.5mg/0.1 ml, was far below the values reported by Le Mer et al 23 and Hrach et al, 26 who observed clinical, electrophysiologic, and histological alterations in cat eyes receiving intravitreal rt-PA doses greater than or equal to 50 mg. Our histologic examinations confirmed the safety of very low dose of rt-PA. There was no difference in the retinal anatomy between mPlm-treated eyes and control eyes.…”
Section: Enzymatic Vitreolysis W Chen Et Alcontrasting
confidence: 60%
“…Together with the cases reported by Lahey and associates 14 and Glacet-Bernhard and colleagues, 15 a total of 47 eyes with CRVO have been reported to have undergone intravitreal tPA injection without any major complication. Although Hrach and coworkers 20 reported fundus pigmentary alterations in cats at a concentration of 50 g/mL, we did not observe retinal pigment changes at this dose. The poor natural history of CRVO, the lack of a safe and effective treatment, the scientific rationale underlying thrombolytic treatment in CRVO, and the apparent relative safety and feasibility of intravitreal tPA injections strongly support further, more definitive investigations of its efficacy and safety in CRVO.…”
Section: Discussioncontrasting
confidence: 99%
“…[16][17][18][19][26][27][28] In this study, to reduce the probability of damaging effects with intravitreous t-PA, we chose 25-50 mg/ml as the range of optimal doses. No retinal pigmentary changes and unexplained visual acuity loss were found, suggesting that concentrations of less than 50 mg/0.1 ml were safe for displacement of submacular haemorrhage in AMD patients.…”
Section: Discussionmentioning
confidence: 99%
“…In both animal models and humans, it has been demonstrated to cause retinal toxicity, including bullous retinal detachment, attenuation of retinal vessels, and marked reduction in electroretinogram. [16][17][18][19] Additionally, experimental studies have shown conflicting results as to whether t-PA injected intravitreally can access the subretinal space in sufficient quantities to liquefy submacular blood clots. [20][21][22] Furthermore, Ohji et al 23 have reported success in pneumatic displacement of subretinal haemorrhage with intravitreal injection of gas alone, without t-PA.…”
Section: Introductionmentioning
confidence: 99%