Kratko priopćenje
Treatment of Post-Traumatic Trabecular Mashwork Thrombosis and Secondary Glaucoma with Intracameral Tissue Plasminogen Activator in Previously Unrecognized Sickle Cell Anemia
Ksenija Karaman
Srdjana Čulić
Ivana Erceg
Vida Čulić
Alen Siničić
Ilza Salamunić
Ljubo Znaor
Sažetak
Intracameral tissue plasminogen activator (t-PA) aplication in a child with previously unrecognized sickle cell anemia,
post-traumatic hyphema, thrombosis in trabecular mashwork and consecutive acute glaucoma showed positive
results. Thirteen year-old boy, son of African father and Caucasian mother, was admitted to hospital, with symptoms
of acute glaucoma and partial hyphema after right eye trauma. 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. Visual acuity was only hand motion (HM) and IOP 53 mmHg. At this point rose suspicion of sickle cell disease
(SCD) and decision about injecting t-PA (20 μg) into anterior chamber was made. Cytological examination of
aqueous humor revealed 10% sickled erythrocytes. Hemoglobin electrophoresis discovered hemoglobin S so that diagnosis
of SCD was confirmed. Intraocular aplication of t-PA showed excellent results in post-traumatic hyphema with
trabecular mashwork thrombosis in the patient with sickle cell anemia. Two-years follow up confirmed permanent normalisation
of IOP and visual acuity. Successful outcome with anterior chamber paracentesis and intracameral injection
of t-PA is promising novel approach, which we recommend in treatment of post-traumatic hyphema in SCD.
Ključne riječi
sickle cell anemia; t-PA, thrombosis; glaucoma; treatment
Hrčak ID:
27897
URI
Datum izdavanja:
20.6.2005.
Posjeta: 979 *