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dc.contributor.authorTameesh, M. K.
dc.contributor.authorLakhanpal, R. R.
dc.contributor.authorFujii, G. Y.
dc.contributor.authorJavaheri, M.
dc.contributor.authorShelley, T. H.
dc.contributor.authorD'Anna, S.
dc.contributor.authorBarnes, A. C.
dc.contributor.authorMargalit, E.
dc.contributor.authorFarah, M.
dc.contributor.authorDe Juan, E.
dc.contributor.authorHumayun, M. S.
dc.identifier.citationAmerican Journal of Ophthalmology. New York: Elsevier B.V., v. 138, n. 5, p. 829-839, 2004.
dc.description.abstractPURPOSE: To evaluate the feasibility, safety, and efficacy of local thrombolytic agents directly injected into occluded retinal veins in an experimental animal model.DESIGN: Experimental animal study.METHODS: This experimental study was performed in two phases. in phase 1, 15 enucleated porcine eyes and 8 in vivo canine eyes were used for the development of the instrumentation and surgical technique required for retinal vein cannulation with prolonged intravascular infusion. in phase 2 of this study, experimental branch retinal vein occlusion was photo,chemically created using an intravenous injection of rose bengal followed by diode laser photo coagulation in eight eyes of eight dogs. Four eyes were treated by retinal vein cannulation and an injection of tissue Plasminogen activator (t-PA) using a specifically designed microcatheter, while the remaining four eyes were untreated (control group). the total amount of t-PA injected intravenously ranged from 400 to 1000 mug, infused over a period ranging from 25 to 45 minutes with a mean pressure of 40 psi, resulting in a mean injection flow rate of 0.05 ml/min. the dogs underwent clinical examination, fluorescein angiography, and histologic examination. Main outcome measures were: Achievement of prolonged intravascular infusionof t-PA, changes in fundus appearance, fluorescein angiography, and histology.RESULTS: A microcatheter instrument and a surgical technique for retinal vein cannulation with prolonged intravascular infusion were developed. Cannulation and t-PA infusion for a period of at least 30 minutes was achieved in all four treated eyes with experimental branch retinal vein occlusion. No complications were recorded in all treated eyes. One week and 1 month postoperatively, treated eyes exhibited marked decreases in retinal hemorrhages, retinal vein dilation, and tortuosity, whereas nontreated eyes exhibited persistence of these findings. Fluorescein angiography demonstrated improved circulatory flow in treated relative to non, treated eyes. Histologic analysis confirmed the presence of thrombi in nontreated eyes only.CONCLUSIONS: Retinal vein cannulation with prolonged intravascular injection of t-PA is feasible and safe, and this may offer a new treatment option for retinal vein occlusion. (C) 2004 by Elsevier Inc. All rights reserved.en
dc.publisherElsevier B.V.
dc.relation.ispartofAmerican Journal of Ophthalmology
dc.rightsAcesso restrito
dc.titleRetinal vein cannulation with prolonged infusion of tissue plasminogen activator (t-PA) for the treatment of experimental retinal vein occlusion in dogsen
dc.contributor.institutionUniv So Calif
dc.contributor.institutionJohns Hopkins Univ
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.description.affiliationUniv So Calif, Keck Sch Med, Doheny Eye Inst, Dept Ophthalmol, Los Angeles, CA 90033 USA
dc.description.affiliationJohns Hopkins Univ, Sch Med, Dept Ophthalmol, Wilmer Ophthalmol Inst, Baltimore, MD USA
dc.description.affiliationUniversidade Federal de São Paulo, Dept Ophthalmol, São Paulo, Brazil
dc.description.affiliationUnifespUniversidade Federal de São Paulo, Dept Ophthalmol, São Paulo, Brazil
dc.description.sourceWeb of Science

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