J Korean Ophthalmol Soc.  2006 Jun;47(6):971-976.

Effects of Neodymium:YAG Laser and Tissue Plasminogen Activator on Massive Diabetic Premacular Hemorrhage

• Park YH
• Lee WK
• Chung J
• Kim HS
• Lee YC

Abstract

PURPOSE: To investigate the combined therapeutic effects of Neodymium:YAG (Nd:YAG) laser membranotomy and intravitreal tissue plasminogen activator (tPA) on massive diabetic premacular hemorrhage.
METHODS
The authors performed Nd:YAG laser membranotomy on the hemorrhagic membrane of premacular hemorrhages and injected tPA (25 microgram) into the vitreous cavity of 5 eyes with massive diabetic premacular hemorrhage. Each time, 0.2 ml of perfluoropropane (C3F8) gas was also injected.
RESULTS
After Nd:YAG laser membranotomy and tPA injection, the patients' vision recovered within 4 weeks and the hemorrhages were completely absorbed within 8 weeks. Visual acuity at the last visit had improved to a mean of 10 lines (8-13 lines) on ETDRS charts for all cases. There were no associated ophthalmic complications. Also, there were no cases that required vitrectomy.
CONCLUSIONS
Combined therapy of Nd:YAG laser membranotomy and tPA injection with an expansive gas is a good alternative method to observation or simple Nd:YAG laser treatment for resolution of premacular hemorrhages in proliferative diabetic retinopathy patients, and may allow for faster resolution of hemorrhages without the complications of vitrectomy.

Keyword

Nd:YAG laser; Premacular hemorrhage; Tissue plasminogen activator

MeSH Terms

Diabetic Retinopathy
Hemorrhage*
Humans
Membranes
Tissue Plasminogen Activator*
Visual Acuity
Vitrectomy
Tissue Plasminogen Activator