Intraocular hemorrhage after systemic thrombolytic therapy in a patient with exudative macular degeneration.

PURPOSE: To report a hemorrhagic complication from thrombolytic therapy in a patient with exudative macular degeneration.

CASE REPORT: A 75 year old patient with exudative macular degeneration developed pain and loss of vision in the left eye shortly after receiving tissue plasminogen activator (t-PA) for a myocardial infarction. Examination revealed the patient to be in angle closure. A CT scan revealed the etiology of the angle closure to be a dense vitreous hemorrhage pushing the iris-lens diaphragm forward. Intraocular pressure was treated successfully, but the final visual acuity was only light perception.

CONCLUSIONS

Thrombolytic therapy can lead to devastating intraocular hemorrhages. The presence of exudative macular degeneration may potentially increase the risk of developing such complications.