Vitreous hemorrhage after intravitreal tissue plasminogen activator (t-PA)and pneumatic displacement of submacular hemorrhage

PURPOSE: To report the immediate complication of dense vitreous hemorrhage after intravitreal injection of tissue plasminogen activator and gas for tr eatment of two cases of sudden submacular hemorrhage associated with retina l arterial macroaneurysm METHODS: Case reports, RESULTS: Two patients, a 67 year-old woman and a 92-year-old man, presented with sudden vision loss related to submacular hemorrhage from a retinal ma croaneurysm. Tissue plasminogen activator at a dose of 50 mu g to 75 mu g a nd a sulfur hexafluoride (SF6) gas bubble were injected intravitreally unde r local anesthesia. Dense vitreous hemorrhage was noted on the first postop erative day in both cases, which subsequently required pars plana vitrectom y removal. CONCLUSION: Sudden severe vitreous hemorrhage may be an immediate complicat ion after intravitreal injection of tissue plasminogen activator and gas fo r treatment of submacular hemorrhage associated with retinal arterial macro aneurysm. (Am J Ophthalmol 2000;129: 546-547. (C) 2000 by Elsevier Science Inc. All rights reserved.).