ArticleInternational journal of surgery case reports2026
Secondary macular hole following subretinal T-PA injection for subretinal hemorrhage: a case report.
Article in International journal of surgery case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction and importance: Case of secondary full-thickness macular hole occurring shortly after surgery for subretinal hemorrhage with the injection of tissue-type plasminogen activator (t-PA) is rare. Case Presentation: We report a case of a 70-year-old Chinese man who underwent vitrectomy combined with subretinal injection of t-PA for subretinal hemorrhage and subsequently developed a macular hole (MH). The patient presented with extensive sub-ILM and subretinal hemorrhage caused by a ruptured retinal arterial macroaneurysm (RAM). One week after the t-PA injection, a secondary full-thickness macular hole developed. The macular hole was successfully closed using autologous blood filling followed by silicone oil tamponade. Clinical Discussion: Subretinal injection of t-PA for treating subretinal hemorrhage may induce macular hole formation, which may occur intraoperatively or postoperatively. Several mechanisms may contribute to this complication, warranting careful use of t-PA. If a macular hole develops, autologous blood filling is a viable option for anatomical closure. Conclusion: Subretinal t-PA can cause early postoperative macular hole. If a macular hole develops, autologous blood filling is a viable option for anatomical closure.
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