Literature Review of Recombinant Tissue Plasminogen Activator Used for Recent-Onset Submacular Hemorrhage Displacement in Age-Related Macular Degeneration

Aims: To review and discuss the literature on recombinant tissue plasminogen activator (rtPA) for the treatment of a recent-onset submacular hemorrhage in patients with age-related macular degeneration. Methods: The administration technique of rtPA, the use of additional gas and vascular endothelial growth factor inhibitors (anti-VEGF), and the displacement rate of submacular hemorrhage and complications were noted from published reports, and a case series from the Rotterdam Eye Hospital (REH). Results: 38 studies with a total of 1,185 patients (1,176 eyes), and 28 patients from the REH were analyzed. Several methods for rtPA administration are available, which can be divided into two groups: submacular rtPA administration with vitrectomy; or intravitreal rtPA administration without vitrectomy. In both groups, the administration of gas and/or anti-VEGF agents could be additional. There appears to be no clear difference in complete displacement or complication rate between the more or the less invasive treatment groups. Conclusion: Although intravitreal injection of rtPA and gas only was reported to be Received: February 29, 2012 Accepted after revision: July 7, 2012 Published online: October 12, 2012 Ophthalmologica Elsbeth J.T. van Zeeburg Rotterdam Ophthalmic Institute Schiedamse Vest 160-D NL–3011 BH Rotterdam (The Netherlands) E-Mail e.vanzeeburg @ oogziekenhuis.nl © 2012 S. Karger AG, Basel 0030–3755/13/2291–0001$38.00/0 Accessible online at: www.karger.com/oph D ow nl oa de d by : 54 .7 0. 40 .1 1 10 /2 /2 01 7 12 :5 1: 02 P M