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Secondary macular hole following subretinal T-PA injection for subretinal hemorrhage: a case report
Xi Lv1, Yanyan Liang2, Man Xu1
1Department of Ophthalmology, Hebei General Hospital, Shijiazhuang, Hebei, China.
Introduction And Importance:
Case of secondary full-thickness macular hole occurring shortly after surgery for subretinal hemorrhage with the injection of tissue-type plasminogen activator (t-PA) is rare.
Case Presentation:
We report a case of a 70-year-old Chinese man who underwent vitrectomy combined with subretinal injection of t-PA for subretinal hemorrhage and subsequently developed a macular hole (MH). The patient presented with extensive sub-ILM and subretinal hemorrhage caused by a ruptured retinal arterial macroaneurysm (RAM). One week after the t-PA injection, a secondary full-thickness macular hole developed. The macular hole was successfully closed using autologous blood filling followed by silicone oil tamponade.
Clinical Discussion:
Subretinal injection of t-PA for treating subretinal hemorrhage may induce macular hole formation, which may occur intraoperatively or postoperatively. Several mechanisms may contribute to this complication, warranting careful use of t-PA. If a macular hole develops, autologous blood filling is a viable option for anatomical closure.
Conclusion:
Subretinal t-PA can cause early postoperative macular hole. If a macular hole develops, autologous blood filling is a viable option for anatomical closure.
