藤原 篤之
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   Position  
Article types 原著
Language English
Peer review Peer reviewed
Title Successful displacement of a traumatic submacular hemorrhage in a 13-year-old boy treated by vitrectomy, subretinal injection of tissue plasminogen activator and intravitreal air tamponade: a case report.
Journal Formal name:BMC ophthalmology
Abbreviation:BMC Ophthalmol
ISSN code:14712415/14712415
Domestic / ForeginForegin
Volume, Issue, Page 15,94頁
Author and coauthor Doi Shinichiro, Kimura Shuhei, Morizane Yuki, Shiode Yusuke, Hosokawa Mio, Hirano Masayuki, Hosogi Mika, Fujiwara Atsushi, Miyamoto Kazuhisa, Shiraga Fumio
Publication date 2015/08
Summary BACKGROUND:The natural course of submacular hemorrhage resulting from traumatic choroidal rupture generally has a poor outcome unless treated. The intravitreal injection of gas only or gas with recombinant tissue plasminogen activator (rt-PA) has been reported to be effective, but has also been reported to induce severe complications such as retinal detachment and vitreous hemorrhage. Recently, we reported a safe and effective procedure for treating submacular hemorrhage due to polypoidal choroidal vasculopathy (PCV) with a low dose of rt-PA. Here we report the application of this procedure to a case of traumatic submacular hemorrhage in a 13-year-old boy, which achieved a good visual outcome.CASE PRESENTATION:A 13-year-old Japanese boy presented with a thick submacular hemorrhage in his left eye as a result of blunt trauma from being hit by a sinker. Best-corrected visual acuity (BCVA) was assessed as only able to perceive hand motions. We carried out a vitrectomy, subretinal injection of 4,000 IU rt-PA (6.9 μg) and air tamponade. The day after surgery, most of the submacular hemorrhage had moved to the inferior periphery. One month after the surgery, we observed cataract formation, thin remnants of the submacular hemorrhage and juxtafoveal choroidal rupture. We carried out cataract surgery and injected bevacizumab intravitreally to prevent the development of choroidal neovascularization. Two months after the second surgery, the submacular hemorrhage had totally disappeared and the patient had a BCVA of 20/40.CONCLUSION:Vitrectomy, subretinal injection of rt-PA, and intravitreal air tamponade may be a promising strategy for treating traumatic submacular hemorrhage in young patients.
DOI 10.1186/s12886-015-0090-3
PMID 26250101