J Korean Ophthalmol Soc.  2008 Mar;49(3):450-455. 10.3341/jkos.2008.49.3.450.

Intravitreal Tissue Plasminogen Activator with C3F8 Injection in Branch Retinal Vein Occlusion

• Lim JW
• Choi JH
• Park IW

• KMID: 2211318
• DOI: http://doi.org/10.3341/jkos.2008.49.3.450

Abstract

PURPOSE: To evaluate the efficacy of intravitreal tissue plasminogen activator (tPA) with C3F8 injection for branch retinal vein occlusion (BRVO) involving fovea.
METHODS
Seven patients (7 eyes) presenting with subfoveal hemorrhage caused by BRVO were treated with an intravitreal tPA and C3F8 injection. We assessed the visual acuity (VA) and foveal thickness measured with optical coherence tomography.
RESULTS
The mean duration of symptoms before surgery was 5.42+/-1.90 weeks. The mean logMAR VA improved from 1.14+/-0.19 at baseline to 0.87+/-0.34 at one week and 0.30+/-0.32 at six months. The mean foveal thickness decreased from 564.421+/-186.88 micrometer at baseline to 483.14+/-275.06 micrometer at one week and 353.28+/-152.99 micrometer at six months. There was no adverse effect related to the treatment.
CONCLUSIONS
Intravitreal tPA with C3F8 injection may be an effective treatment for resolving macular edema with subfoveal hemorrhage and improving the VA in recently developed BRVO.

Keyword

Branch retinal vein occlusion; Intravitreal injection; Tissue plasminogen activator

MeSH Terms

Hemorrhage
Humans
Intravitreal Injections
Macular Edema
Retinal Vein
Retinal Vein Occlusion
Retinaldehyde
Tissue Plasminogen Activator
Tomography, Optical Coherence
Visual Acuity
Retinaldehyde
Tissue Plasminogen Activator

Figure

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  Figure 1. The left eye of a 66-year-old woman (patient 4) was treated with an intravitreal tPA and C3 F8 injection after 4 weeks of visual symptom. (A) Pretreatment fundus photograph. The fovea was affected by edema and hemorrhage. Visual acuity was 0.06. (B) Pretreatment OCT showed macular edema with foveal thickness of 372 µm. (C) Fundus photograph of 1 month after treatment. Visual acuity improved to 0.2. (D) OCT of 1 month after treatment shows decreased macular edema. Foveal thickness was 316 µm. (E) Fundus photograph of 6 months after treatment showed that the intraretinal hemorrhage was almost absorbed and the macular edema resolved. visual acuity improved to 0.3. (F) OCT showed that retinal thickness is markedly reduced with foveal thickness of 214 µm.

• 

  Figure 2. The left eye of a 56-year-old man (patient 2) with sudden decrease in vision of 7 days duration. (A) Initial fundus photograph with superotemporal branch vein occlusion. Visual acuity was 0.15. (B) Pretreatment fundus photograph with increasing intraretinal hemorrhage. visual acuity was 0.15. (C) Fundus photograph 1 day after intravitreal tPA and C3 F8 injection. macular hemorrhage was displaced. (D) Fundus photograph 6 months after treatment. The macular area was still affected by remaining retinal hemorrhage. Visual acuity was 0.1. (E) Pretreatment OCT showed cystic space at the fovea and the sensory retina is thickened with foveal thickness of 422 µm. (F) OCT 6 months after treatment showed stationary macular edema. Foveal thickness was 443 µm.

Reference

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