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The effect of tissue plasminogen activator on retinal bleeding
P Sternberg1, H E Aguilar, C Drews
1Department of Ophthalmology, Emory University School of Medicine, Atlanta, Ga 30322.
Archives of Ophthalmology (Chicago, Ill. : 1960)
|May 1, 1990
Summary
Tissue plasminogen activator (tPA) can cause significant intraocular bleeding, especially when administered after retinal vessel injury. This study found a high incidence of bleeding in rabbit eyes treated with tPA post-vitrectomy.
Area of Science:
- Ophthalmology
- Vascular Biology
- Pharmacology
Background:
- Tissue plasminogen activator (tPA) is a thrombolytic agent used for postvitrectomy fibrin.
- Intracameral tPA has been associated with intraocular bleeding complications.
- The safety of tPA in specific ocular surgical contexts requires further investigation.
Purpose of the Study:
- To evaluate the risk of intraocular hemorrhage following intracameral tissue plasminogen activator (tPA) injection in a rabbit model with induced retinal vascular injury.
Main Methods:
- Lensectomy and vitrectomy were performed on 20 rabbits.
- A retinal blood vessel was intentionally incised to simulate intraocular hemorrhage.
- Eyes received either tPA (25 micrograms) or balanced salt solution postoperatively.
Main Results:
- Eyes treated with tPA showed a 28% incidence of increased anterior chamber blood.
- A 61% incidence of increased intravitreal blood was observed in tPA-treated eyes.
- No postinjection bleeding occurred in eyes receiving balanced salt solution.
Conclusions:
- Intracameral tPA administration in eyes with compromised retinal vasculature increases the risk of intraocular hemorrhage.
- tPA should be used with caution in the setting of segmented or injured blood vessels post-vitrectomy.
- Further research is needed to establish safe protocols for tPA use in ophthalmology.