Subretinal tissue plasminogen-assisted vitrectomy for posttraumatic full-thickness macular hole with submacular hemorrhage

Indian J Ophthalmol. 2018 Mar;66(3):474-476. doi: 10.4103/ijo.IJO_815_17.

Abstract

A young male presented with diminution of vision left eye, attributable to full-thickness macular hole, and submacular hemorrhage, following closed globe injury 2 weeks ago. The patient was managed successfully with 25-gauge vitrectomy, subretinal injection of tissue plasminogen activator and aspiration of liquefied blood through the macular hole, internal limiting membrane peeling, short-acting gas tamponade, and prone positioning. This resulted in good visual improvement, type 1 macular hole closure, and restoration of foveal architecture. The outcome and rationale of treatment in this unique scenario is discussed.

Keywords: Closed globe injury; full-thickness macular hole; pars plana vitrectomy; subretinal hemorrhage; subretinal tissue plasminogen activator.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Combined Modality Therapy
  • Drainage
  • Eye Injuries / diagnosis
  • Eye Injuries / etiology
  • Eye Injuries / therapy*
  • Fibrinolytic Agents / therapeutic use*
  • Humans
  • Male
  • Retinal Hemorrhage / diagnosis
  • Retinal Hemorrhage / etiology
  • Retinal Hemorrhage / therapy*
  • Retinal Perforations / diagnosis
  • Retinal Perforations / etiology
  • Retinal Perforations / therapy*
  • Subretinal Fluid
  • Tissue Plasminogen Activator / therapeutic use*
  • Tomography, Optical Coherence
  • Visual Acuity / physiology
  • Vitrectomy / methods*
  • Wounds, Nonpenetrating / diagnosis
  • Wounds, Nonpenetrating / etiology
  • Wounds, Nonpenetrating / therapy*

Substances

  • Fibrinolytic Agents
  • Tissue Plasminogen Activator