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Sequential treatment of central retinal vein occlusion with intravitreal tissue plasminogen activator and intravitreal triamcinolone
  1. J M L1,
  2. J J K1,2,
  3. M C Cheung1,
  4. J M Lahey2
  1. 1Ophthalmology, University of California at San Francisco, San Francisco, CA, USA
  2. 2Ophthalmology, Kaiser Permanente, Hayward, CA, USA
  1. Correspondence to: J M Lahey MD Ophthalmology (Retina), Kaiser Permanente Medical Center, 27400 Hesperian Boulevard, Hayward, CA 94545-4299, USA;

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Treatment for central retinal vein occlusion (CRVO) remains disappointing despite recently proposed intraocular surgical techniques.1,2 We previously introduced the use of intravitreal tissue plasminogen activator (TPA) for acute central retinal vein occlusion in 1999.3 Numerous investigators have confirmed its safety and suggested that it may have a beneficial role in the treatment of acute central retinal vein occlusion.4–7 Although some studies in rabbits suggest the rabbit retina is not permeable to TPA, investigators found the porcine retina was, in fact, permeable to TPA.8,9 Our clinical experience with intravitreal TPA in humans with CRVO and large submacular haemorrhages strongly suggests that intravitreal TPA does cross the …

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