Open Access

Subretinal alteplase injections in massive subretinal hemorrhage due to age‑related macular degeneration: A case report series

  • Authors:
    • Radu Ochinciuc
    • Florian Balta
    • Daniel Constantin Branisteanu
    • Marian Burcea
    • Mihail Zemba
    • Uliana Ochinciuc
    • Ramona Barac
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  • Published online on: October 14, 2020     https://doi.org/10.3892/etm.2020.9338
  • Article Number: 208
  • Copyright: © Ochinciuc et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

This report describes a series of cases with massive subretinal hemorrhage (SRH) due to age‑related macular degeneration (AMD) treated by subretinal alteplase injections. In all cases, the surgical technique consisted in 25‑gauge pars plana vitrectomy (PPV) and alteplase injection under the retina using a 38‑gauge cannula. After the fluid‑gas exchange, bevacizumab injection was performed in all patients. Three cases of SRH in which this technique was used, as well as their evolution at one week and one month postoperatively are described. Visual acuity was hand motion in all three cases at presentation. After surgery, a significant anatomical and functional improvement was noted in all cases. One month postoperatively, none of the patients had blood under the macula, and visual acuities significantly improved to 0.8, 0.2 and 0.16 (decimal fraction). A consistent reduction of central retinal thickness was observed on optical coherence tomography (OCT) from the first week postoperatively. No intra and postoperative complications were noted. Subretinal alteplase injection proved as a viable solution in these severe SRH with early presentation. There was no need to change the systemic anticoagulant and antiaggregant therapy. Bevacizumab intravitreal injection at the end of surgery has an important role in preventing further bleeding.
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December-2020
Volume 20 Issue 6

Print ISSN: 1792-0981
Online ISSN:1792-1015

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Spandidos Publications style
Ochinciuc R, Balta F, Branisteanu DC, Burcea M, Zemba M, Ochinciuc U and Barac R: Subretinal alteplase injections in massive subretinal hemorrhage due to age‑related macular degeneration: A case report series. Exp Ther Med 20: 208, 2020.
APA
Ochinciuc, R., Balta, F., Branisteanu, D.C., Burcea, M., Zemba, M., Ochinciuc, U., & Barac, R. (2020). Subretinal alteplase injections in massive subretinal hemorrhage due to age‑related macular degeneration: A case report series. Experimental and Therapeutic Medicine, 20, 208. https://doi.org/10.3892/etm.2020.9338
MLA
Ochinciuc, R., Balta, F., Branisteanu, D. C., Burcea, M., Zemba, M., Ochinciuc, U., Barac, R."Subretinal alteplase injections in massive subretinal hemorrhage due to age‑related macular degeneration: A case report series". Experimental and Therapeutic Medicine 20.6 (2020): 208.
Chicago
Ochinciuc, R., Balta, F., Branisteanu, D. C., Burcea, M., Zemba, M., Ochinciuc, U., Barac, R."Subretinal alteplase injections in massive subretinal hemorrhage due to age‑related macular degeneration: A case report series". Experimental and Therapeutic Medicine 20, no. 6 (2020): 208. https://doi.org/10.3892/etm.2020.9338