Tissue plasminogen activating factor assisted removal of subretinal hemorrhage

Ophthalmic Surg. 1991 Oct;22(10):575-82.


We used tissue plasminogen activator (tPA) to aid in the surgical evacuation of subretinal hemorrhages. Subretinal hemorrhage secondary to a ruptured retinal macroaneurysm was treated in two patients. The surgical technique involved using a micropipette to fashion a small retinotomy through which tPA was injected into the subretinal space and through which the dissolved clot was removed. Visual acuity improved from counts fingers to 20/50 in one patient and from counts fingers to 20/70 in the other. Three additional patients, with massive subretinal hemorrhages secondary to age-related macular degeneration, were similarly treated. In one, visual acuity improved from counts fingers to 20/400; in two others, visual acuity was stabilized; in the first patient, at 20/300, and in the second patient at 20/400. The use of tPA minimizes surgical manipulation of the sensory retina and greatly reduces the size of the retinotomy required for evacuation of subretinal blood.

Publication types

  • Case Reports
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aneurysm / complications
  • Female
  • Fluorescein Angiography
  • Fundus Oculi
  • Humans
  • Intraoperative Complications
  • Macular Degeneration / complications
  • Male
  • Middle Aged
  • Postoperative Complications
  • Retinal Detachment / diagnostic imaging
  • Retinal Hemorrhage / etiology
  • Retinal Hemorrhage / surgery
  • Retinal Hemorrhage / therapy*
  • Retinal Vessels
  • Rupture, Spontaneous
  • Tissue Plasminogen Activator / therapeutic use*
  • Ultrasonography
  • Visual Acuity
  • Visual Fields


  • Tissue Plasminogen Activator