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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 effectivene...

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Main Authors: AR, Siti Noor Atikah, Mohd Khialdin, Safinaz, Mustapha, Mushawiahti, MS, Muhammad Syamil, MZ, Ayesha
Format: Article
Published: Universiti Kebangsaan Malaysia. Faculty of Medicine 2022
Online Access:http://psasir.upm.edu.my/id/eprint/101972/
https://www.researchgate.net/publication/361620632_Intracameral_Recombinant_Tissue_Plasminogen_Activator_rtPA_as_the_Primary_Treatment_for_Secondary_Pupillary_Block
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spelling my.upm.eprints.1019722024-03-15T03:47:45Z http://psasir.upm.edu.my/id/eprint/101972/ Intracameral recombinant tissue plasminogen activator (rtPA) as the primary treatment for secondary pupillary block AR, Siti Noor Atikah Mohd Khialdin, Safinaz Mustapha, Mushawiahti MS, Muhammad Syamil MZ, Ayesha 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. Universiti Kebangsaan Malaysia. Faculty of Medicine 2022 Article PeerReviewed AR, Siti Noor Atikah and Mohd Khialdin, Safinaz and Mustapha, Mushawiahti and MS, Muhammad Syamil and MZ, Ayesha (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.researchgate.net/publication/361620632_Intracameral_Recombinant_Tissue_Plasminogen_Activator_rtPA_as_the_Primary_Treatment_for_Secondary_Pupillary_Block 10.17576/MH.2022.1701.24
institution Universiti Putra Malaysia
building UPM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Putra Malaysia
content_source UPM Institutional Repository
url_provider http://psasir.upm.edu.my/
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 AR, Siti Noor Atikah
Mohd Khialdin, Safinaz
Mustapha, Mushawiahti
MS, Muhammad Syamil
MZ, Ayesha
spellingShingle AR, Siti Noor Atikah
Mohd Khialdin, Safinaz
Mustapha, Mushawiahti
MS, Muhammad Syamil
MZ, Ayesha
Intracameral recombinant tissue plasminogen activator (rtPA) as the primary treatment for secondary pupillary block
author_facet AR, Siti Noor Atikah
Mohd Khialdin, Safinaz
Mustapha, Mushawiahti
MS, Muhammad Syamil
MZ, Ayesha
author_sort AR, Siti Noor Atikah
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 Universiti Kebangsaan Malaysia. Faculty of Medicine
publishDate 2022
url http://psasir.upm.edu.my/id/eprint/101972/
https://www.researchgate.net/publication/361620632_Intracameral_Recombinant_Tissue_Plasminogen_Activator_rtPA_as_the_Primary_Treatment_for_Secondary_Pupillary_Block
_version_ 1794564333677576192
score 13.211869

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