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June 1989, Vol 107, No. 6 >
ARTICLE | June 1989

Intravitreal Tissue Plasminogen Activator Treatment of Experimental Vitreous Hemorrhage FREE

Robert N. Johnson, MD; Karl R. Olsen, MD; Eleut Hernandez
[+] Author Affiliations

Accepted for publication Nov 23, 1988.

Presented in part at the Annual Meeting of the Association for Research in Vision and Ophthalmology, Sarasota, Fla, May 6, 1988, and at the 24th Bascom Palmer Eye Institute Residents' Day, Miami, June 10, 1988.

Reprint requests to Bascom Palmer Eye Institute, PO Box 016880, Miami, FL 33101 (Dr Olsen).


Arch Ophthalmol. 1989;107(6):891-894. doi:10.1001/archopht.1989.01070010913040
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References
Comments

• Intraocular recombinant DNA human tissue-type plasminogen activator (tPA) can promote rapid resolution of intraocular fibrin clots and hyphema. The efficacy of intravitreal tPA in promoting the shortterm clearance of vitreous hemorrhage was investigated. Five treatment groups with experimentally induced vitreous hemorrhage were studied. The extent of the vitreous hemorrhage was graded based on the visibility of retinal details in each quadrant. Two weeks following intravitreal tPA injection (50 000 IU), the nonvitrectomized group and gas vitrectomy groups, each of which received a single tPA injection, showed a statistically significant reduction of the vitreous hemorrhage, although this was thought to represent only a modest clinical effect. Tractional retinal detachments were noted to develop more frequently in tPA-treated eyes as compared with controls.

REFERENCES

1 +
Johnson RN, Olsen K, Hernandez E:  Tissue plasminogen activator treatment of postoperative intraocular fibrin . Ophthalmology 1988;;95:592-596.
2 +
Lambrou FH, Snyder MD, Williams GA, et al:  Treatment of experimental intravitreal fibrin with tissue plasminogen activator . Arch Ophthalmol 1987;;104:619-623.
3 +
Snyder RW, Lambrou FH, Williams GA:  Intraocular fibrinolysis with recombinant human tissue plasminogen activator . Arch Ophthalmol 1987;;105:1277-1280.
4 +
Lambrou FH, Snyder RW, Williams GA:  The use of tissue plasminogen activator in experimental hyphema . Arch Ophthalmol 1987;;105:995-997.
5 +
Vine AK, Maguire PT, Martonyi C, et al:  Recombinant tissue plasminogen activator to lyse experimentally induced retinal arterial thrombi . Am J Ophthalmol 1988;;105:266-270.
6 +
Jukofsky SL:  A new technique in the treatment of hyphema: A preliminary report . Am J Ophthalmol 1951;;34:1692-1696.
7 +
Friedman MW:  Streptokinase in ophthalmology . Am J Ophthalmol 1952;;35:1184-1187.
8 +
Horven I, Opsahl R:  Fibrinolysis and hyphema . Acta Ophthalmol 1964;;42:957-961.
9 +
Scheie HG, Ashley BJ, Burns DT:  Treatment of total hyphema with fibrinolysin . Arch Ophthalmol 1963;;69:147-153.
10 +
Heath W:  Experience with urokinase in secondary traumatic hyphema . Eye 1966;;86:843-844.
11 +
Pierse D, LeGrice H:  Urokinase in ophthalmology . Lancet 1963;;2:1143-1144.
12 +
Pierse D, LeGrice H:  The use of urokinase in the anterior chamber of the eye . J Clin Pathol 1964;;17:362.
13 +
Rakusin W:  Urokinase in the management of traumatic hyphaema . Br J Ophthalmol 1971;;55:826-832.
14 +
Forrester J, Williamson J:  Resolution of intravitreal clots by urokinase . Lancet 1973;;2:179-181.
15 +
Forrester JV, Edgar W, Prentice CRM, et al:  Intravitreal fibrinolysis in experimental vitreous haemorrhage . Exp Eye Res 1976;;22:181-188.
16 +
Forrester JV, Williamson J:  Total vitreous haemorrhage: A method of treatment . Eye 1974;;94:992-999.
17 +
Dugmore WN, Raichand M:  Intravitreal urokinase in the treatment of vitreous hemorrhage . Am J Ophthalmol 1973;;75:779-781.
18 +
Forrester JV, Williamson J:  Lytic therapy in vitreous hemorrhage . Eye 1974;;94:583-586.
19 +
Maberley AL, Chisholm LDJ:  The effect of a fibrinolytic agent on vitreous hemorrhage in rabbits . Can J Ophthalmol 1970;;5:55-64.
20 +
Sellors PJH, Kanski JJ, Watson DM:  Intravitreal urokinase in the management of vitreous hemorrhage . Eye 1974;;94:591-598.
21 +
Cleary PE, Davies EWG, Shilling JS, et al:  Intravitreal urokinase in the treatment of vitreous haemorrhage . Eye 1974;;94:587-590.
22 +
Chapman-Smith JS, Crock GW:  Urokinase in the management of vitreous haemorrhage . Br J Ophthalmol 1977;;61:500-505.
23 +
Koziol J, Peyman GA, Sanders DR, et al:  Urokinase in experimental vitreous hemorrhage . Ophthalmic Surg 1975;;6:79-82.
24 +
Milligan KR:  Tissue-type plasminogen activator: A new fibrinolytic agent . Heart Lung 1987;;16:69-75.
25 +
Topol EJ, O'Neill WW, Langburd AB, et al:  A randomized, placebo-controlled trial of intravenous recombinant tissue-type plasminogen activator and emergency coronary angioplasty in patients with acute myocardial infarction . Circulation 1987;;75:420-428.
26 +
Verstraete M:  A far-reaching program: Rapid, safe, and predictable thrombolysis in man , in Kline DL, Reddy KNN (eds): Fibrinolysis , ed 1. Boca Raton, Fla, CRC Press Inc, 1980;, pp 186-187.
27 +
Collen D, Lijnen HR:  Tissue-type plasminogen activator: Mechanism of action and thrombolytic properties . Haemostasis 1986;;16( (suppl) ):25-32.
28 +
Vidaurri-Leal JS, Glaser BM:  Effect of fibrin on morphologic characteristics of retinal pigment epithelial cells . Arch Ophthalmol 1984;;102:1376-1379.

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1 +
Johnson RN, Olsen K, Hernandez E:  Tissue plasminogen activator treatment of postoperative intraocular fibrin . Ophthalmology 1988;;95:592-596.
2 +
Lambrou FH, Snyder MD, Williams GA, et al:  Treatment of experimental intravitreal fibrin with tissue plasminogen activator . Arch Ophthalmol 1987;;104:619-623.
3 +
Snyder RW, Lambrou FH, Williams GA:  Intraocular fibrinolysis with recombinant human tissue plasminogen activator . Arch Ophthalmol 1987;;105:1277-1280.
4 +
Lambrou FH, Snyder RW, Williams GA:  The use of tissue plasminogen activator in experimental hyphema . Arch Ophthalmol 1987;;105:995-997.
5 +
Vine AK, Maguire PT, Martonyi C, et al:  Recombinant tissue plasminogen activator to lyse experimentally induced retinal arterial thrombi . Am J Ophthalmol 1988;;105:266-270.
6 +
Jukofsky SL:  A new technique in the treatment of hyphema: A preliminary report . Am J Ophthalmol 1951;;34:1692-1696.
7 +
Friedman MW:  Streptokinase in ophthalmology . Am J Ophthalmol 1952;;35:1184-1187.
8 +
Horven I, Opsahl R:  Fibrinolysis and hyphema . Acta Ophthalmol 1964;;42:957-961.
9 +
Scheie HG, Ashley BJ, Burns DT:  Treatment of total hyphema with fibrinolysin . Arch Ophthalmol 1963;;69:147-153.
10 +
Heath W:  Experience with urokinase in secondary traumatic hyphema . Eye 1966;;86:843-844.
11 +
Pierse D, LeGrice H:  Urokinase in ophthalmology . Lancet 1963;;2:1143-1144.
12 +
Pierse D, LeGrice H:  The use of urokinase in the anterior chamber of the eye . J Clin Pathol 1964;;17:362.
13 +
Rakusin W:  Urokinase in the management of traumatic hyphaema . Br J Ophthalmol 1971;;55:826-832.
14 +
Forrester J, Williamson J:  Resolution of intravitreal clots by urokinase . Lancet 1973;;2:179-181.
15 +
Forrester JV, Edgar W, Prentice CRM, et al:  Intravitreal fibrinolysis in experimental vitreous haemorrhage . Exp Eye Res 1976;;22:181-188.
16 +
Forrester JV, Williamson J:  Total vitreous haemorrhage: A method of treatment . Eye 1974;;94:992-999.
17 +
Dugmore WN, Raichand M:  Intravitreal urokinase in the treatment of vitreous hemorrhage . Am J Ophthalmol 1973;;75:779-781.
18 +
Forrester JV, Williamson J:  Lytic therapy in vitreous hemorrhage . Eye 1974;;94:583-586.
19 +
Maberley AL, Chisholm LDJ:  The effect of a fibrinolytic agent on vitreous hemorrhage in rabbits . Can J Ophthalmol 1970;;5:55-64.
20 +
Sellors PJH, Kanski JJ, Watson DM:  Intravitreal urokinase in the management of vitreous hemorrhage . Eye 1974;;94:591-598.
21 +
Cleary PE, Davies EWG, Shilling JS, et al:  Intravitreal urokinase in the treatment of vitreous haemorrhage . Eye 1974;;94:587-590.
22 +
Chapman-Smith JS, Crock GW:  Urokinase in the management of vitreous haemorrhage . Br J Ophthalmol 1977;;61:500-505.
23 +
Koziol J, Peyman GA, Sanders DR, et al:  Urokinase in experimental vitreous hemorrhage . Ophthalmic Surg 1975;;6:79-82.
24 +
Milligan KR:  Tissue-type plasminogen activator: A new fibrinolytic agent . Heart Lung 1987;;16:69-75.
25 +
Topol EJ, O'Neill WW, Langburd AB, et al:  A randomized, placebo-controlled trial of intravenous recombinant tissue-type plasminogen activator and emergency coronary angioplasty in patients with acute myocardial infarction . Circulation 1987;;75:420-428.
26 +
Verstraete M:  A far-reaching program: Rapid, safe, and predictable thrombolysis in man , in Kline DL, Reddy KNN (eds): Fibrinolysis , ed 1. Boca Raton, Fla, CRC Press Inc, 1980;, pp 186-187.
27 +
Collen D, Lijnen HR:  Tissue-type plasminogen activator: Mechanism of action and thrombolytic properties . Haemostasis 1986;;16( (suppl) ):25-32.
28 +
Vidaurri-Leal JS, Glaser BM:  Effect of fibrin on morphologic characteristics of retinal pigment epithelial cells . Arch Ophthalmol 1984;;102:1376-1379.

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