Use of recombinant tissue plasminogen activator for treatment of recalcitrant anterior uveitis: A case series

Publication date: Available online 6 April 2018 Source:Journal of Taibah University Medical Sciences Author(s): Sylves Patrick, Hui-Tze Chan, Wan Hazabbah Wan Hitam, Zunaina Embong, Yaakub Azhany, Liza-Sharmini Ahmad Tajudin Management of inflammation after surgery for recalcitrant anterior uveitis is challenging. Herein, we report successful treatment using intracameral injection of recombinant tissue plasminogen activator (rtPA) in two patients with recalcitrant anterior uveitis, due to infective uveitis and Vogt–Koyanagi–Harada disease, respectively. A 40-year-old woman presented with bilateral redness and vision reduction that had persisted 2 weeks. She also had bilateral anterior uveitis, vasculitis, retinitis, and optic disc swelling. Serology was positive for Bartonella henselae and Toxoplasma gondii. She was treated using long-term systemic corticosteroids and appropriate antibiotics. Our second case was that of a healthy, 30-year-old man with reduced vision and redness without pain in both eyes, as well as headache and tinnitus, that had persisted for 2 weeks. He showed bilateral granulomatous inflammation with vitritis, choroiditis, retinitis, and hyperemic optic disc. The patient was diagnosed with Vogt-Koyanagi-Harada disease and treated with systemic corticosteroids. Both patients developed secondary cataracts and glaucoma that necessitated surgical intervention. Persistent chronic inflammation led to the formation of a thick fibrin membrane anterior ...
Source: Journal of Taibah University Medical Sciences - Category: Universities & Medical Training Source Type: research