황반하출혈 환자에서 조직형 플라스미노겐 활성제(tPA) 주입술 후 발생한 망막독성 1예

• 영문명: Retinal Toxicity of Intravitreal Tissue Plasminogen Activator on Submacular Hemorrhage
• 발행기관: 대한안과학회
• 저자명: 정종진 조성원,Jong Jin Jung, MD, Sung Won Cho, MD
• 간행물 정보: 『대한안과학회지』Ophthalmological Society,volume50,number5, 800~803쪽, 전체 4쪽
• 주제분류: 의약학 > 기타의약학
• 파일형태: PDF
• 발행일자: 2009.05.15

영문 초록

Purpose: To present the clinical feature of retinal toxicity of intravitreal tissue plasminogen activator which was used for treatment of submacular hemorrhage. Case summary: An intravitreal injection of tPA (100 μg) with C3F8 gas tamponade (0.2 cc) was given to treat the submacular hemorrhage in a patient with ARMD. The therapeutic effect was measured by visual acuity, slit lamp examination, indirect funduscopy and fluorescein angiogram. Three months after the operation, the hemorrhage was decreased but a pigmentary change was observed on the peripheral retina. After 8 months, the submacular hemorrhage completely reabsorbed but the peripheral pigmentary change had increased. Ten months later, the retinal pigmentary change was observed on the entire retina except the posterior pole. The fluorescein angiogram showed peripheral hyperfluorescene of the retina due to window defect from the pigmentary change but no leakage was detected. The electroretinogram showed reduced amplitude in the right eye. Conclusions: Intravitreal tPA injection of 25 to 100 μg with pneumatic displacement is typically used for the treatment of submacular hemorrhage. However, there is no established safety dose of tPA for use in human eyes. In the present study, 100 μg of tPA was used and retinal toxicity was noted. Establishing a safety dose of tPA to prevent dosage dependent complications is necessary.

키워드

ARMD, Retinal toxicity, Submacular hemorrhage, tPA