Purpose: to evaluate the effect of Intravitreal tissue plasminogen activator (r-tPA) injection on improvement\r\nof visual acuity and decreasing the rate of complications in Branch Retinal Vein Occlusion (BRVO) and ischemic\r\nComplications in Retinal Vein Occlusion (CRVO).\r\nMethods: 10 patients with BRVO and 19 patients with ischemic CRVO of recent onset (from 4 to 30 days duration)\r\nand visual acuity of <=20/50 were given 100 microgram of tPA intravitreally. Ischemia was defined as an area of\r\nnonperfusion >=10 DD for CRVO and >=5 DD for BRVO. Follow up schedule contained 6 visits : at the time of injection,\r\nand 1 week,1 month, 2months, 3months, and 6 months after. Fluorescein angiography was performed before injection\r\nand at the end of the study.\r\nResults: In ischemic CRVO group: only one eye (5.6%) developed Iris neovascularization. The mean of baseline\r\nvisual acuity increased from 1.8400 LogMAR to 1.5333 LogMAR at the end of the study (p=0.009). Pearson correlation\r\ncoefficient was +0.874 for initial and final measured BCVAs. 8 patients (44.4%) had doubling of visual angle (0.3\r\nLogMAR increase in BCVA).\r\nIn BRVO group: 3 patients (30%) were classified in the ischemic group and after a complete 6 month follow up none\r\nof the cases (0%) developed retinal neovascularization, vitreous hemorrhage, retinal detachment or endophthalmitis.\r\nThe mean of baseline visual acuity increased from 1.0710 LogMAR to 0.6100 at the end of the study (p=0.001).\r\nDiscussion: Comparison between the results of our study and natural history of RVO indicates that after injection:\r\nThere was doubling of visual angle in about 10% of cases. The rate of Iris neovascularization and neovascular glaucoma\r\nwas decreased to 1/6 of what occurs without treatment.\r\nEndophthalmitis, retinal detachment and vitreous hemorrhage which are known as major complications of this\r\nprocedure did not occur in any of our 29 patients.
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