Document Detail


Tissue plasminogen activator to treat impending pupillary block glaucoma in patients with acute fibrinous HLA-B27 positive iridocyclitis.
MedLine Citation:
PMID:  10704553     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To report the use of intracameral tissue plasminogen activator to dissolve fibrinous membranes and break posterior synechiae in patients with acute HLA-B27-positive iridocyclitis with impending pupillary block. METHODS: Two patients with severe acute fibrinous iridocyclitis and seclusio pupillae were identified. Because of the concern of impending pupillary block, intracameral tissue plasminogen activator (12.5 microg in 0.1 ml, Activase; Genentech, Inc, South San Francisco, California) was injected with a 25-gauge needle through the corneal limbus. RESULTS: Both patients showed complete dissolution of fibrin with disruption of posterior synechiae. There were no adverse events after injection. Neither patient required further invasive intervention, and both fully recovered with medical management. CONCLUSIONS: Intracameral tissue plasminogen activator is a safe and effective agent for patients with severe acute iridocyclitis and pupillary seclusion. Patients with clinical signs suggestive of impending pupillary block glaucoma may be considered for tissue plasminogen activator injection to avoid the possible need for emergency surgical iridectomy and synechiolysis.
Authors:
C A Skolnick; R G Fiscella; H H Tessler; D A Goldstein
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  American journal of ophthalmology     Volume:  129     ISSN:  0002-9394     ISO Abbreviation:  Am. J. Ophthalmol.     Publication Date:  2000 Mar 
Date Detail:
Created Date:  2000-04-04     Completed Date:  2000-04-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0370500     Medline TA:  Am J Ophthalmol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  363-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago College of Medicine, Chicago, IL 60612-7243, USA.
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Fibrin / drug effects
Fibrinolysis / drug effects
Fibrinolytic Agents / therapeutic use*
Glaucoma / etiology,  pathology,  prevention & control*
HLA-B27 Antigen / analysis*
Humans
Iridocyclitis / blood,  complications*
Male
Pupil Disorders / etiology,  pathology,  prevention & control*
Tissue Plasminogen Activator / therapeutic use*
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; 0/HLA-B27 Antigen; 9001-31-4/Fibrin; EC 3.4.21.68/Tissue Plasminogen Activator

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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