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

Publication date: Available online 6 April 2018Source: Journal of Taibah University Medical SciencesAuthor(s): Sylves Patrick, Chan Hui-Tze, Wan Hitam Wan-Hazabbah, Embong Zunaina, Yaakub Azhany, Ahmad Tajudin Liza-SharminiAbstractManagement 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; a healthy 30-year-old man with bilateral eye redness and reduced vision without pain, and associated with headache and tinnitus for 1 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 to the intraocular lens ...
Source: Journal of Taibah University Medical Sciences - Category: Universities & Medical Training Source Type: research