[Vitreous hemorrhage after vitrectomy in diabetic retinopathy and tissue plasminogen activator]. / Hemorragia vítrea postvitrectomía en retinopatía diabética y activador tisular del plasminógeno.

PURPOSE: To determine if intraocular recombinant tissue plasminogen activator (r-TPA) can be used to treat fibrin blood clots (hyphemas/vitreous) after vitrectomy surgery for diabetic retinopathy. MATERIAL AND METHOD: After a retrospective review of medical records, we found 52 patients who underwent vitrectomy for diabetic retinopathy and non-resolving vitreous hemorrhage and/or hyphema during the early postoperative (6 weeks). They were administered r-TPA in dose of 25 microgr/0.1 ml. Hyphemas and vitreous hemorrhages were classified in four grades. RESULTS: Tissue Plasminogen Activator was used after vitrectomy surgery in 52 fibrin clotted eyes (52 patients), within the first 3 days post surgery. Vitreous hemorrhages were categorized as grade 2 (21%), grade 3 (67.3%) and grade 4 (11.5%). Hyphemas observed in 18 eyes presented grade 3 (38.9%) and grade 4 (61%). We saw no evidence of intraocular reactions against the r-TPA solution at the dose used in this study. CONCLUSIONS: Fibrin blood clots can successfully and effectively be treated with intraocular r-TPA in doses of 25 microgr/0.1 ml (Arch Soc Esp Oftalmol 2002; 77: 7-12).

[Suprachoroidal haemorrhage and acute glaucoma associated with systemic fibrinolysis]. / Hemorragia supracoroidea y glaucoma agudo asociado a fibrinolisis sistémica.

PURPOSE/METHOD: To describe the clinical case of a patient with acute myocardial infarction and an ocular haemorrhage as a complication of the use of systemic thrombolytic agents. RESULTS/CONCLUSIONS: A patient who received therapy with tissue plasminogen activator for an acute myocardial infarction developed three hours later a massive suprachoroidal haemorrhage with secondary acute angle closure. In patients who have undergone systemic thrombolytic agents, the presence of loss of vision and pain must alert to the possibility of secondary ocular haemorrhage. These patients may benefit from continuous control (Arch Soc Esp Oftalmol 2002; 77: 459-462).