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January 2002

Treating Subretinal Hemorrhage With Tissue Plasminogen Activator

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Copyright 2002 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.2002

Arch Ophthalmol. 2002;120(1):102-103. doi:

Currently, the use of intravitreally injected tissue plasminogen activator (tPA) and expansile gas is an effective treatment to rapidly displace subretinal hemorrhage. I read with interest the recent article by Handwerger et al,1 who presented a retrospective series of 14 patients. However, I believe that some points in this study should be clarified.

First, I am surprised that the supplier of tPA was not mentioned in the article. Detailed information about the dilution volume and buffer used would be of great value because both can severely influence the enzymatic activity of tPA. The reader would also like to know what type of syringe was used that allows a differentiation between 18, 20, 24, and 30 µg of injected tPA? What was the rationale for injecting 5 different doses of tPA in a series of 14 patients?

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