Manning L M, Conrad D K
Mater Misericordiae Hospital, Brisbane.
Aust N Z J Ophthalmol. 1994 Feb;22(1):59-63. doi: 10.1111/j.1442-9071.1994.tb01697.x.
We report three cases of the use of tissue plasminogen activator (TPA) to aid the surgical removal of subretinal haemorrhage. All patients had choroidal neovascular membranes secondary to age-related macular degeneration. The technique involved infusing a sterile solution of TPA through a small retinotomy and irrigating out the dissolved clot. The visual acuity improved in the first patient from a preoperative 6/36 to 6/18 five weeks after surgery, but subsequently deteriorated to 6/60 after six months from a new choroidal neovascular membrane (CNVM), remaining 6/60 at nine months after surgery. The second patient's visual acuity improved from count fingers to 6/24 three weeks after surgery, but subsequently deteriorated to 6/60 after four months from a new CNVM, remaining 6/60 at nine months after surgery. The third patient's visual acuity improved from count fingers to 6/36 and remains stable at 6/36, eight months after surgery. Although long-term prognosis remains guarded, these early results suggest that TPA may have a role in the management of subretinal haemorrhage.
我们报告了3例使用组织型纤溶酶原激活剂（TPA）辅助手术清除视网膜下出血的病例。所有患者均患有年龄相关性黄斑变性继发的脉络膜新生血管膜。该技术包括通过小的视网膜切开术注入TPA无菌溶液并冲洗出溶解的血块。首例患者术后5周视力从术前的6/36提高到6/18，但6个月后因新的脉络膜新生血管膜（CNVM）视力恶化至6/60，术后9个月仍为6/60。第二例患者术后3周视力从数指提高到6/24，但4个月后因新的CNVM视力恶化至6/60，术后9个月仍为6/60。第三例患者术后8个月视力从数指提高到6/36，且保持在6/36稳定。尽管长期预后仍不乐观，但这些早期结果表明TPA可能在视网膜下出血的治疗中发挥作用。
