Intravitreal injection of tissue plasminogen activator and gas in subretinal hemorrhage caused by age-related macular degeneration

Purpose: To assess the efficacy and safety of intravitreal injection of rec ombinant tissue plasminogen activator and sulfur hexafluoride gas for displ acement of subretinal hemorrhages in patients with age-related macular dege neration. Methods: The authors injected 25 mug of recombinant tissue plasminogen acti vator and 0.5 mt sulfur hexafluoride gas intravitreally in 11 patients with subretinal hemorrhages of less than 3 weeks duration. Anatomic and functio nal results were evaluated. Results: Displacement of subretinal blood was successful within the first w eek after surgery in 10 of 11 patients. This was accompanied by visual impr ovement in eight patients. After 1 year, visual acuity was better than befo re surgery in five patients. Diagnosis of a choroidal neovascularization by fluorescein angiography was possible in all patients, and was treated with laser photocoagulation in five. The authors observed no adverse effects of treatment. Conclusion: Recombinant tissue plasminogen activator and gas effectively di splace subretinal blood in patients with age-related macular degeneration. Randomized studies are necessary to prove the benefit of this simple and sa fe method in patients with subretinal hemorrhage due to age-related macular degeneration.