Induction of Posterior Vitreous Detachment in Pediatric Vitrectomy by Preoperative Intravitreal Injection of Tissue Plasminogen Activator
| Autor: | San Ni Chen, Chih Chun Chuang |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Male
0301 basic medicine medicine.medical_specialty Visual acuity genetic structures medicine.medical_treatment Vitrectomy Vitreoretinal Surgery Vitreous Detachment Posterior vitreous detachment 03 medical and health sciences 0302 clinical medicine Fibrinolytic Agents Retinal Diseases Ophthalmology Preoperative Care medicine Humans Child Macular hole Retrospective Studies business.industry Infant Retinopathy of prematurity General Medicine medicine.disease eye diseases 030104 developmental biology Child Preschool Tissue Plasminogen Activator Intravitreal Injections Pediatrics Perinatology and Child Health Vitreous hemorrhage 030221 ophthalmology & optometry Female medicine.symptom business Tomography Optical Coherence Fibrinolytic agent |
| Zdroj: | Journal of Pediatric Ophthalmology & Strabismus. 53:113-118 |
| ISSN: | 1938-2405 0191-3913 |
| DOI: | 10.3928/01913913-20160209-01 |
| Popis: | Purpose: To report the efficacy of intravitreal injection of tissue plasminogen activator (tPA) with or without autoserum in induction of posterior vitreous detachment (PVD) in pediatric vitrectomy. Methods: Retrospective, interventional case series of pediatric patients receiving intravitreal injection of tPA preoperatively to facilitate PVD in vitrectomy from January 2011 to December 2014 at the Changhua Christian Hospital, Taiwan. All patients received intravitreal injections of 25 µg of tPA 3 days before vitrectomy. For cases without preexisting vitreous hemorrhage, 0.1 mL of intravitreal autologous serum was co-administered. Main outcome measures included successful rate of posterior vitreous detachment in vitrectomy, visual outcome, and related ocular complications. Results: Four boys and 2 girls were included. Ages ranged from 39 weeks' postmenstrual age to 8 years. The indications for vitrectomy were traumatic macular hole (cases 1 and 2); premacular hemorrhage secondary to retinopathy of prematurity (case 3); abusive head trauma with premacular hemorrhage, subinternal limiting membrane hemorrhage, and macular hole (case 4); trauma with dense vitreous hemorrhage (case 5); and vitreous hemorrhage with unknown cause (case 6). Successful PVD was induced intraoperatively in all cases and the macular hole was closed successfully in 3 of 3 cases (cases 1, 2, and 4). No surgical complications were noted. Visual outcome improved in all 3 eyes with checkable preoperative visual acuity (cases 1, 2, and 6). Conclusions: Intravitreal injection of tPA 3 days before vitrectomy may be a helpful adjunct to induce pediatric PVD. [ J Pediatr Ophthalmol Strabismus . 2016;53(2):113–118.] |
| Databáze: | OpenAIRE |
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