Abstract

P 198

Intravitreal application of rT-PA without additive gas in macular hemorrhages

Matthias Schmidt, Anna Tsymanava, Michael R. R. Böhm, Holger Busse, Constantin E. Uhlig
Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Münster, Münster

Objective
Intra- or subretinal macular hemorrhages are prevalently treated with intravitreal application of rT-PA combined with gas injection. Side effects are usually correlated to the frequence of surgical manipulation which might motivate to treat macular hemorrhages without additional gas injection. This leads to the question, if an exclusive intravitreal application of rT-PA is adequate therapeutical effective.
Methods
Retrospective analysis of patients with central macular hemorrhages who were intravitreally treated with rT-PA but without additional gas. Visual acuity measured with Snellen letters (5 m distance). Required minimal follow-up was 4 weeks. Patients were separated into groups that received 50 µg (group I), 100 µg (group II), and 200 µg (group III).
Results
18 eyes of 12 female and 6 male patients. Mean age was 70,2 years (min. 16, max. 90 years). Mean follow-up was 10,9, max. 47 months. Visual acuity over time was: Group I at baseline =0,078, and at final examination = 0,032. Group II at baseline = 0,077, and at final examination = 0,142. Group III at baseline = 0,124, and at final examination = 0,056. One side effect was observed (retinal hemorrhage, 24th day post injectionem). Systemical or severe ophthalmological side effects like endophthalmitis or retinal detachment did not occur.
Conclusions
Treatment of macular hemorrhages with intravitreal rT-PA but without additive gas injection was associated with only few side effects which, due to its late incidence, may not be correlated to the therapy, and resulted in a visual acuity improvement in group II (100 µg). Further studies are necessary to investigate if, concerning efficiency and side effects, treatment without gas is superior to the therapy with additive intravitreal gas injection.

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