Intracameral recombinant tissue plasminogen activator (rtPA) as the primary treatment for secondary pupillary block

Alteplase is a recombinant form of human tissue plasminogen activator (tPA) that converts plasminogen to plasmin essential for fibrinolysis. It is commonly used to treat embolic or thrombotic disorders such as ischemic stroke. Despite its rarity use in ophthalmology, we are reporting the effectiv...

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Main Authors: Siti Noor Atikah AR,, Safinaz Mohd Khialdin,, Mushawiahti Mustapha,, Muhammad Syamil MS,, Ayesha MZ,
Format: Article
Language:English
Published: Pusat Perubatan Universiti Kebangsaan Malaysia 2022
Online Access:http://journalarticle.ukm.my/19680/1/24_ms0517_pdf_18838.pdf
http://journalarticle.ukm.my/19680/
https://www.medicineandhealthukm.com/toc/17/1
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spelling my-ukm.journal.196802022-09-12T03:23:15Z http://journalarticle.ukm.my/19680/ Intracameral recombinant tissue plasminogen activator (rtPA) as the primary treatment for secondary pupillary block Siti Noor Atikah AR, Safinaz Mohd Khialdin, Mushawiahti Mustapha, Muhammad Syamil MS, Ayesha MZ, Alteplase is a recombinant form of human tissue plasminogen activator (tPA) that converts plasminogen to plasmin essential for fibrinolysis. It is commonly used to treat embolic or thrombotic disorders such as ischemic stroke. Despite its rarity use in ophthalmology, we are reporting the effectiveness of recombinant tissue plasminogen activator (rtPA) in treating an eye with secondary pupillary block as a consequence of severe endophthalmitis. A patient presented with acute endophthalmitis after a complicated cataract extraction. Examination showed severe anterior chamber reaction leading to seclusion pupillae, iris bombe and presence of iridocorneal touch 360-degree. Following intracameral alteplase 2.5 microgram in 0.1 ml given, iris bombe was observed to resolve completely onehour later. Anterior chamber was also significantly deeper and slightly larger pupil compared to before rtPA injection. Due to clearer view of anterior segment, pars planar vitrectomy and extraction of intraocular lens could be performed with significant visual improvement after surgery. Our findings suggest that usage of rtPA, which is alteplase, was effective in treating secondary pupillary block due to intense anterior segment inflammation in endophthalmitis cases. Thus it is useful in replacing the conventional use of laser peripheral iridotomy in treating pupillary block, as the latter potentially aggravates the pre-existing inflammatory condition. Pusat Perubatan Universiti Kebangsaan Malaysia 2022-06 Article PeerReviewed application/pdf en http://journalarticle.ukm.my/19680/1/24_ms0517_pdf_18838.pdf Siti Noor Atikah AR, and Safinaz Mohd Khialdin, and Mushawiahti Mustapha, and Muhammad Syamil MS, and Ayesha MZ, (2022) Intracameral recombinant tissue plasminogen activator (rtPA) as the primary treatment for secondary pupillary block. Medicine & Health, 17 (1). pp. 302-307. ISSN 2289-5728 https://www.medicineandhealthukm.com/toc/17/1
institution Universiti Kebangsaan Malaysia
building Tun Sri Lanang Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Kebangsaan Malaysia
content_source UKM Journal Article Repository
url_provider http://journalarticle.ukm.my/
language English
description Alteplase is a recombinant form of human tissue plasminogen activator (tPA) that converts plasminogen to plasmin essential for fibrinolysis. It is commonly used to treat embolic or thrombotic disorders such as ischemic stroke. Despite its rarity use in ophthalmology, we are reporting the effectiveness of recombinant tissue plasminogen activator (rtPA) in treating an eye with secondary pupillary block as a consequence of severe endophthalmitis. A patient presented with acute endophthalmitis after a complicated cataract extraction. Examination showed severe anterior chamber reaction leading to seclusion pupillae, iris bombe and presence of iridocorneal touch 360-degree. Following intracameral alteplase 2.5 microgram in 0.1 ml given, iris bombe was observed to resolve completely onehour later. Anterior chamber was also significantly deeper and slightly larger pupil compared to before rtPA injection. Due to clearer view of anterior segment, pars planar vitrectomy and extraction of intraocular lens could be performed with significant visual improvement after surgery. Our findings suggest that usage of rtPA, which is alteplase, was effective in treating secondary pupillary block due to intense anterior segment inflammation in endophthalmitis cases. Thus it is useful in replacing the conventional use of laser peripheral iridotomy in treating pupillary block, as the latter potentially aggravates the pre-existing inflammatory condition.
format Article
author Siti Noor Atikah AR,
Safinaz Mohd Khialdin,
Mushawiahti Mustapha,
Muhammad Syamil MS,
Ayesha MZ,
spellingShingle Siti Noor Atikah AR,
Safinaz Mohd Khialdin,
Mushawiahti Mustapha,
Muhammad Syamil MS,
Ayesha MZ,
Intracameral recombinant tissue plasminogen activator (rtPA) as the primary treatment for secondary pupillary block
author_facet Siti Noor Atikah AR,
Safinaz Mohd Khialdin,
Mushawiahti Mustapha,
Muhammad Syamil MS,
Ayesha MZ,
author_sort Siti Noor Atikah AR,
title Intracameral recombinant tissue plasminogen activator (rtPA) as the primary treatment for secondary pupillary block
title_short Intracameral recombinant tissue plasminogen activator (rtPA) as the primary treatment for secondary pupillary block
title_full Intracameral recombinant tissue plasminogen activator (rtPA) as the primary treatment for secondary pupillary block
title_fullStr Intracameral recombinant tissue plasminogen activator (rtPA) as the primary treatment for secondary pupillary block
title_full_unstemmed Intracameral recombinant tissue plasminogen activator (rtPA) as the primary treatment for secondary pupillary block
title_sort intracameral recombinant tissue plasminogen activator (rtpa) as the primary treatment for secondary pupillary block
publisher Pusat Perubatan Universiti Kebangsaan Malaysia
publishDate 2022
url http://journalarticle.ukm.my/19680/1/24_ms0517_pdf_18838.pdf
http://journalarticle.ukm.my/19680/
https://www.medicineandhealthukm.com/toc/17/1
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score 13.211869