Tissue plasminogen activator and gas for diabetic premacular hemorrhage.

Abstract

To report the effect of intravitreal injection of tissue plasminogen activator and gas for the treatment of diabetic premacular hemorrhage. Five eyes of five consecutive patients with fresh diabetic premacular hemorrhage and previous panretinal photocoagulation were treated with intravitreal injection of 50 microg of tissue plasminogen activator, and 0.3 ml of sulfur hexafluoride. After intravitreal injection, patients maintained a prone position for 3 days and were followed for an average of 7 months (range, 6 to 8 months). All eyes had clearing of the premacular hemorrhage with improved visual acuity. Three eyes with no visible fibrovascular proliferation required 3 weeks to resorb the hemorrhage, and two eyes with active fibrovascular proliferation needed 2 months to resorb the intravitreal hemorrhage. Intravitreal injection of tissue plasminogen activator and gas may be an effective way to treat fresh diabetic premacular hemorrhage.