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RHEGMATOGENOUS RETINAL DETACHMENT AFTER INJECTION OF TISSUE PLASMINOGEN ACTIVATOR AND GAS FOR SUBMACULAR HEMORRHAGE
Roslyn Manrique-Lipa1, Haneen Jasim, Antoine Safi
1Bristol Eye Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Lower Maudlin Street, Bristol, United Kingdom.
Retinal Cases & Brief Reports
|August 25, 2022
Summary
Rhegmatogenous retinal detachment (RRD) occurred in 7% of eyes after submacular hemorrhage displacement using tissue plasminogen activator (TPA) and gas. Outcomes were poor, especially after subretinal TPA with vitrectomy.
Area of Science:
- Ophthalmology
- Retinal Surgery
- Vitreoretinal Diseases
Background:
- Submacular hemorrhage displacement using tissue plasminogen activator (TPA) and gas is a treatment for certain retinal conditions.
- Rhegmatogenous retinal detachment (RRD) is a potential complication following ocular procedures.
Purpose of the Study:
- To determine the incidence and clinical characteristics of RRD after TPA and gas for submacular hemorrhage displacement.
- To analyze the anatomical and visual outcomes of RRD repair in this patient cohort.
Main Methods:
- Retrospective analysis of 90 eyes undergoing TPA and gas for submacular hemorrhage displacement.
- Calculation of RRD rate and detailed description of RRD clinical features.
- Evaluation of anatomical success and visual acuity following RRD repair.
Main Results:
- RRD occurred in 7% of eyes (6/90), with a higher incidence noted after vitrectomy with subretinal TPA (P=0.04).
- All RRD cases involved macular pathology, and 17% achieved primary single surgery success.
- Median final visual acuity was poor (1.8 logMAR), and five eyes required silicone oil retention.
Conclusions:
- The rate of RRD following submacular hemorrhage displacement was 7% in this series.
- Subretinal TPA combined with vitrectomy was associated with a higher risk of RRD.
- Outcomes for RRD after this procedure were generally poor, with significant challenges in achieving anatomical and visual recovery.
