Back to Journals » Clinical Ophthalmology » Volume 5

Recombinant tissue plasminogen activator in the treatment of suprachoroidal hemorrhage

Authors Kunjukunju N, Gonzales CR, Rodden WS

Published 4 February 2011 Volume 2011:5 Pages 155—157


Review by Single anonymous peer review

Peer reviewer comments 4

Nancy Kunjukunju1, Christine R Gonzales2, William S Rodden2
1Ochsner Medical Center, New Orleans, Louisiana; 2Retina and Vitreous Center of Southern Oregon, Ashland, Oregon, USA

Background: Suprachoroidal hemorrhages are a vision-threatening complication, and poor visual outcome is correlated with increasing hemorrhage complexity. The recommended time of surgical drainage is 10–14 days after the hemorrhage begins to liquefy. We describe a case in which recombinant tissue plasminogen activator (r-tPA), alteplase, is injected within the suprachoroidal space before surgery to assist in the drainage of an organized clot prior to liquefaction. This is a report of a technique in which r-tPA is used in the intrachoroidal space to target the organized clot of suprachoroidal hemorrhage prior to drainage.
Case report: A 62-year-old male presented 12 days after retinal detachment repair with sudden ocular pain and vision loss after a Valsalva maneuver. Vision was light perception only, and intraocular pressure was 43 mmHg. Diagnosed with hyphema and suprachoroidal hemorrhage, the patient underwent surgery the following day. An injection of r-tPA 100 µg was given intracamerally, and an additional dose of r-tPA 100 µg was injected into the suprachoroidal space prior to surgery. Liquified by r-tPA, the clot was expressed through the sclerotomies. Best corrected vision in the eye eight months after the drainage procedure was 20/40.
Conclusion: To the author’s knowledge, this is the first reported case in which r-tPA was successfully injected in the suprachoroidal space to liquefy and drain a suprachoroidal hemorrhage prior to natural dissolution.

Keywords: tPA, suprachoroidal hemorrhage, vision loss

Creative Commons License © 2011 The Author(s). This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.