Pars plana vitrectomy with tissue plasminogen activator for traumatic submacular hemorrhage
AIM: To evaluate visual outcomes of pars plana vitrectomy (PPV) combined with tissue plasminogen activator (tPA)-induced clot lysis and pneumatic displacement for submacular hemorrhage (SMH) in a cohort of closed-globe trauma patients. METHODS: A retrospective, multicenter interventional case series...
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Press of International Journal of Ophthalmology (IJO PRESS)
2025-09-01
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| Series: | International Journal of Ophthalmology |
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| Online Access: | http://ies.ijo.cn/en_publish/2025/9/20250922.pdf |
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| author | Wilson X. Wang Kishan G. Patel Henok Getahun Srishti Ramamurthy Howard Chen Raja Narayanan Rajendra S. Apte |
| author_facet | Wilson X. Wang Kishan G. Patel Henok Getahun Srishti Ramamurthy Howard Chen Raja Narayanan Rajendra S. Apte |
| author_sort | Wilson X. Wang |
| collection | DOAJ |
| description | AIM: To evaluate visual outcomes of pars plana vitrectomy (PPV) combined with tissue plasminogen activator (tPA)-induced clot lysis and pneumatic displacement for submacular hemorrhage (SMH) in a cohort of closed-globe trauma patients. METHODS: A retrospective, multicenter interventional case series involving 7 eyes of 7 patients who underwent PPV with subretinal tPA administration for SMH secondary to closed-globe injury were conducted. The primary outcome measure was the change in Snellen visual acuity. RESULTS: The mean age of patients was 32y (range: 21-51y), with a mean follow-up duration of 4.6mo (range: 1.1-14.9mo). The average best-corrected visual acuity (BCVA) was 20/1020 at baseline and 20/114 at the final visit, respectively (P=0.025). Preoperative BCVA was not a significant predictor of final BCVA (r=0.102, P=0.827). Final BCVA did not differ significantly between patients who underwent PPV within 14d of symptom onset and those who underwent surgery after 14d (P=0.57). All eyes received SF6 or C3F8 gas tamponade. CONCLUSION: Surgical intervention involving tPA-mediated clot lysis and pneumatic displacement may yield visual benefits in trauma-induced SMH without underlying retinal vascular disease; however, larger prospective studies are warranted to confirm these findings. |
| format | Article |
| id | doaj-art-9a24c3e1b5d74ff598b4c4f6ab7a5dc2 |
| institution | Kabale University |
| issn | 2222-3959 2227-4898 |
| language | English |
| publishDate | 2025-09-01 |
| publisher | Press of International Journal of Ophthalmology (IJO PRESS) |
| record_format | Article |
| series | International Journal of Ophthalmology |
| spelling | doaj-art-9a24c3e1b5d74ff598b4c4f6ab7a5dc22025-08-22T06:07:08ZengPress of International Journal of Ophthalmology (IJO PRESS)International Journal of Ophthalmology2222-39592227-48982025-09-011891797180210.18240/ijo.2025.09.2220250922Pars plana vitrectomy with tissue plasminogen activator for traumatic submacular hemorrhageWilson X. Wang0Kishan G. Patel1Henok Getahun2Srishti Ramamurthy3Howard Chen4Raja Narayanan5Rajendra S. Apte6Rajendra S. Apte. Campus box 8096, 660 South Euclid Avenue, St. Louis, MO 63110, USA. apte@wustl.eduUT Southwestern Medical Center, Dallas, Texas 75390, USAWashington University in St Louis School of Medicine, St. Louis, MO 63110, USALV Prasad Eye Institute, Hyderabad, Telangana 500034, IndiaWashington University in St Louis School of Medicine, St. Louis, MO 63110, USALV Prasad Eye Institute, Hyderabad, Telangana 500034, IndiaJohn F. Hardesty, MD Department of Ophthalmology and Visual SciencesAIM: To evaluate visual outcomes of pars plana vitrectomy (PPV) combined with tissue plasminogen activator (tPA)-induced clot lysis and pneumatic displacement for submacular hemorrhage (SMH) in a cohort of closed-globe trauma patients. METHODS: A retrospective, multicenter interventional case series involving 7 eyes of 7 patients who underwent PPV with subretinal tPA administration for SMH secondary to closed-globe injury were conducted. The primary outcome measure was the change in Snellen visual acuity. RESULTS: The mean age of patients was 32y (range: 21-51y), with a mean follow-up duration of 4.6mo (range: 1.1-14.9mo). The average best-corrected visual acuity (BCVA) was 20/1020 at baseline and 20/114 at the final visit, respectively (P=0.025). Preoperative BCVA was not a significant predictor of final BCVA (r=0.102, P=0.827). Final BCVA did not differ significantly between patients who underwent PPV within 14d of symptom onset and those who underwent surgery after 14d (P=0.57). All eyes received SF6 or C3F8 gas tamponade. CONCLUSION: Surgical intervention involving tPA-mediated clot lysis and pneumatic displacement may yield visual benefits in trauma-induced SMH without underlying retinal vascular disease; however, larger prospective studies are warranted to confirm these findings.http://ies.ijo.cn/en_publish/2025/9/20250922.pdfsubmacular hemorrhagesubretinaltissue plasminogen activatorclot lysispneumatic displacement |
| spellingShingle | Wilson X. Wang Kishan G. Patel Henok Getahun Srishti Ramamurthy Howard Chen Raja Narayanan Rajendra S. Apte Pars plana vitrectomy with tissue plasminogen activator for traumatic submacular hemorrhage International Journal of Ophthalmology submacular hemorrhage subretinal tissue plasminogen activator clot lysis pneumatic displacement |
| title | Pars plana vitrectomy with tissue plasminogen activator for traumatic submacular hemorrhage |
| title_full | Pars plana vitrectomy with tissue plasminogen activator for traumatic submacular hemorrhage |
| title_fullStr | Pars plana vitrectomy with tissue plasminogen activator for traumatic submacular hemorrhage |
| title_full_unstemmed | Pars plana vitrectomy with tissue plasminogen activator for traumatic submacular hemorrhage |
| title_short | Pars plana vitrectomy with tissue plasminogen activator for traumatic submacular hemorrhage |
| title_sort | pars plana vitrectomy with tissue plasminogen activator for traumatic submacular hemorrhage |
| topic | submacular hemorrhage subretinal tissue plasminogen activator clot lysis pneumatic displacement |
| url | http://ies.ijo.cn/en_publish/2025/9/20250922.pdf |
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