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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Main Authors: Wilson X. Wang, Kishan G. Patel, Henok Getahun, Srishti Ramamurthy, Howard Chen, Raja Narayanan, Rajendra S. Apte
Format: Article
Language:English
Published: Press of International Journal of Ophthalmology (IJO PRESS) 2025-09-01
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.
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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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