PubMed · 6056344
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M Szmigielski. 1967. [Electroretinography: Difficulties, errors, artefacts].. https://pubmed.ncbi.nlm.nih.gov/6056344/
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PURPOSE: To present a case of occult macular dystrophy accompanying normal-tension glaucoma. DESIGN: Observational case report. METHODS: Visual function and ophthalmoscopic and electroretinographic findings in a 56-year-old man suffering from gradually progressive photophobia and visual dysfunction were followed up over 4 years. RESULTS: Best-corrected visual acuity was below 20/200, and intraocular pressures remained in the low teens in both eyes. A wedge-shaped visual field defect in the right eye, corresponding to the enlarged disk cupping, and a relative central scotoma in the left were detected. Ophthalmoscopy and fluorescein angiography detected no apparent abnormality at the macular region in either eye. Severely attenuated multifocal electroretinographic responses were recorded from only the central areas, with normal full-field responses. CONCLUSION: Clinicians must look for additional pathologic conditions in patients with normal-tension glaucoma who have unexplained central visual dysfunction.
OBJECTIVE: To present the clinical picture of retinal toxicity of commercial tissue plasminogen activator (tPA). DESIGN: Case report and literature review. METHODS: Two successive intravitreal injections of tPA (50 micro g) 3 days apart with gas tamponade were given to treat a 49-year-old man with submacular hemorrhage. The adverse consequences of this treatment were monitored. A literature review of retinal toxicity of commercial tPA in animals was also done. MAIN OUTCOME MEASURES: Retinal findings, electroretinograph (ERG) and visual acuity testing. RESULTS: Diffuse pigmentary alterations sparing the posterior pole, poor visual acuity after the absorption of submacular hemorrhage, reduced scotopic and photopic ERG A- and B-waves were noted. CONCLUSIONS: This is the first reported case of retinal toxicity of commercial tPA in humans that resembles the descriptions of tPA-mediated retinal toxicity in animal models. The dosage of intravitreal tPA (between 50 and 100 micro g) may be toxic to the human retina.