Intravitreal Actilyse® injection to induce posterior vitreous detachment in eyes with recent onset of retinal vein occlusion

Abstract

To assess the efficacy of intravitreally injected tissue plasminogen activator (t-PA, Alteplase [Actilyse®]) to induce posterior vitreous detachment (PVD) in eyes with recent onset of retinal vein occlusion (RVO). Retrospective patient chart analysis. Nine eyes were included thereof 4 eyes (44%) with central (CRVO) and 5 eyes (56%) with branch RVO (BRVO). One week after injection none of the eyes treated showed PVD formation. After 12 months one patient (17%) developed partial PVD and two patients (33%) demonstrated complete PVD. All eyes developing (partial) PVD after one year suffered from BRVO. Mean best corrected visual acuity (BCVA) increased from 0.35 to 0.45 after one week (p = 0.401) and further to 1.0 after 12 months (p = 0.042). There was an overall significant gain in mean BCVA development after 12 months (p = 0.015). Mean central retinal thickness decreased from 572 to 485 µm after one week (p = 0.374) and further to 299 µm after 12 months (p = 0.345). There was an overall significant decrease in CRT development from injection until month 12 (p = 0.030). Intravitreally injected Actilyse® might have the potential to induce PVD in eyes with recent onset of RVO and might favorably impact standard treatment regimens. A prospective and randomized clinical trial is needed to prove this hypothesis.