http://www.evrs.eu/medias/2006/congress/Vitrase-for-Vitreous-Hemorrhage-Revisited.swf

Michael A. Singer, MD (San Antonio, TX), Rafael Lin Wong, (San Antonio, TX), Catherine Alderete, CMA (San Antonio, TX), Robin D. Hartman, BBA (San Antonio, TX)

PURPOSE:

To determine whether Vitrase is effective in clearing of vitreous hemorrhage and at what point in time hemorrhage clears enough to adequately assess pathology and treatment.

METHODS:

Prospective study of patients with severe, grade 4, vitreous hemorrhage defined by inability to see retina adequately for PRP (panretinal photocoagulation). Clinical assessments were performed at day 1, week 1, week 2, week 3, and week 4-post injection. Variables assessed included demographics, medical history, initial and final vision, duration of hemorrhage, and systemic medications.

RESULTS:

A total of 13 patients met criteria for inclusion and received a single intravitreal injection of Vitrase. (9) 69% of patients revealed reduced density grades from dense hemorrhage in all 12-clock hours, allowing treatment by panretinal photocoagulation; (6) 67% within seven days, (2) 22% within 14 days, and (1) 11% within 21 days. (4) 31% of the patients did not reveal significant reduction in density grades, and as a result required a Pars Plana Vitrectomy. (10) 77% of the patients obtained an improvement in visual acuity; of which (5) 50% improved to 20/80 or better. In addition, of statistical significance, 75% of the patients failing to clear were on a current anticoagulant treatment.

CONCLUSION:

(9) 69% of patients cleared within 21 days. A recent study of Vitrase failed to consider evaluations within 30 days. Our study shows that earlier assessments may reveal a true beneficial effect of Vitrase vs. Observation and may provide an opportunity to administer PRP before additional bleeding begins. A correlation between Vitrase and anticoagulants warrants further investigation as well.
* Financial interest disclosed