Naslov
Treatment of Post-Traumatic Trabecular Mashwork Thrombosis and Secondary Glaucoma with Intracameral Tissue Plasminogen Activator in Previously Unrecognized Sickle Cell Anemia.

Autori
Karaman, Ksenija ; Čulić, Srđana ; Erceg, Ivana ; Čulić, Vida ; Siničić, Alen ; Salamunić, Ilza ; Znaor, Ljubo

Izvornik
Collegium Antropologicum (0350-6134) 29 (2005), Suppl. 1; 123-126

Vrsta, podvrsta i kategorija rada
Radovi u časopisima, članak, stručni

Ključne riječi
post-traumatic hyphema; trabecular mashwork thrombosis; acute glaucoma; sickle cell anemia; intracameral tissue plasminogen activator

Sažetak
Background. The aim of this study is to present a benefit of intracameral aplication of tissue plasminogen activator (t-PA) in a child with previously unrecognized sickle cell anemia, post-traumatic partially coagulated hyphema, sickling of red cells causing thrombosis in trabecular mashwork with consecutive acute glaucoma. Patient and Methods. Thirteen year-old African boy was admitted to hospital, after right eye trauma with symptoms of acute glaucoma and partial hyphema. Visual acuity of affected eye was 0.5 and intraocular pressure (IOP) 46 mm Hg. Despite a common therapy three days later clinical condition of patient's right eye was getting worst expressing total hyphema. Visual acuity was only hand motion (HM) and IOP 53 mmHg. Aqueous humor with hyphema was aspirated and 20 µ ; g of t-PA was injected into anterior chamber contemporary. Cytological examination of aqueous humor revealed 10% sickled erythrocytes, hemoglobin electrophoresis discovered hemoglobin S and diagnosis of sickle cell disease (SCD) was confirmed. Unsolved trabecular mashwork thrombosis was indication for second intracameral aplication of 20 μ g t-PA. Results. Intraocular aplication of t-PA has revealed excellent results in complications caused by post-traumatic hyphema with trabecular mashwork thrombosis in patient with sickle cell anemia. Complete resolution of blood cloth in the anterior chamber and trabecular mashwork was achieved. One-year follow up revealed permanent normalisation of IOP and visual acuity. Conclusion. Successful outcome with anterior chamber paracentesis and intracameral injection of t-PA is our encouraging novel approach, which we highly recommend in treatment of post-traumatic hyphema in SCD. In such cases antifibrinolytics are contraindicated.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

POVEZANOST RADA