Recombinant Tissue Plasminogen Activator-assisted Early Drainage of Suprachoroidal Hemorrhage

A middle-aged male patient with bilateral advanced glaucoma, who had undergone trabeculectomy, developed a suprachoroidal hemorrhage (SCH) on post-operative day 1. Ultrasound (USG) confirmed the presence of appositional choroidal mounds with clotted blood in the suprachoroidal space. The patient underwent recombinant tissue plasminogen activator (rtPA) injection into the suprachoroidal space in the first stage, followed by trocar-assisted drainage 5 hours later. This report aims to highlight the effectiveness of rtPA in aiding the lysis and subsequent drainage of clotted blood from the suprachoroidal space. This technique is especially useful when early drainage of SCH is being planned because of appositional/kissing choroidals or uncontrolled intraocular pressure (IOP), especially in one-eyed patients.