Skip to main content
Log in

Intravitreal recombinant tissue plasminogen activator in the treatment of experimentally induced bacterial endophthalmitis

  • Published:
International Ophthalmology Aims and scope Submit manuscript

Abstract

Intravitreal injection of antibiotics has been shown to be effective in the treatment of bacterial endophthalmitis, but does not prevent the formation of fibrin. Recombinant tissue plasminogen activator (rTPA), a fibrinolytic agent, was evaluated in experimentally inducedStaphylococcus aureus endophthalmitis in an animal model. Significant fibrinous reaction in the vitreous was present in three of six eyes treated with intravitreal injection of clindamycin and rTPA (50%) and in one of five eyes treated with clindamycin only (20%). Fibrin clot formation in the anterior chamber was present in two of six eyes treated with clindamycin and rTPA (33%) and not observed in the clindamycin treated eyes (0%). These findings suggest that rTPA does not play a beneficial role in the treatment of bacterial endophthalmitis in the presence of the vitreous.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Agnelli G, Buchanan MR, Fernandez F et al. A comparison of the thrombolytic and hemorrhagic effects of tissue-type plasminogen activator and streptokinase in rabbits. Circulation 1985; 72: 178–182.

    Article  CAS  PubMed  Google Scholar 

  2. Aoki N, Moroi M, Sakata Y et al. Plasmin inhibitor: Primary natural inhibitor of fibrinolysis. In: Ed Davidson JF, Nilsson IM & Astedt B. Progress in Fibrinolysis. Vol. 5. 144–151. Edinburgh UK: Churchill Livingstone, 1981.

    Google Scholar 

  3. Camiolo SM, Thorsen S, Astrup T. Fibrinogenolysis and fibrinolysis with tissue plasminogen activator, urokinase, streptokinase-activated human globulin, and plasmin. Proc Soc Exp Biol Med 1971; 138: 277–280.

    Article  CAS  PubMed  Google Scholar 

  4. Collen D, Stassen JM, Marafino BJ et al. Biological properties of human tissue-type plasminogen activator obtained by expression of recombinant DNA in mammalian cells. J Pharmacol Exp Ther 1984; 231: 146–152.

    CAS  PubMed  Google Scholar 

  5. Collen D. On the regulation and control of fibrinolysis. Thromb Haemost 1980; 43: 77–89.

    CAS  PubMed  Google Scholar 

  6. Geanon JD, Tripathi BJ, Tripathi RC et al. Tissue plasminogen activator in avascular tissues of the eye: A quantitative study of its activity in the cornea, lens, and aqueous and vitreous humors of dog, calf, and monkey. Exp Eye Res 1987; 44: 55–63.

    Article  CAS  PubMed  Google Scholar 

  7. Graham RO, Peyman GA. Intravitreal injection of dexamethasone: Treatment of experimentally induced endophthalmitis. Arch Ophthalmol 1974; 92: 149–154.

    Article  CAS  PubMed  Google Scholar 

  8. Hoylaerts M, Rijken DC, Lijnen HR et al. Kinetics of the activation of plasminogen by human tissue plasminogen activator. Role of fibrin. J Biol Chem 1982; 257: 2912–2919.

    CAS  PubMed  Google Scholar 

  9. Johnson RN, Balyest E, Stern WH. Heparin prophylaxis for intraocular fibrin. Ophthalmology 1987; 94: 597–601.

    Article  CAS  PubMed  Google Scholar 

  10. Johnson RN, Blankenship G. A prospective, randomized, clinical trial of heparin therapy for postoperative intraocular fibrin. Ophthalmology 1988; 95: 312–317.

    Article  CAS  PubMed  Google Scholar 

  11. Johnson RN, Olsen KR, Hernandez E. Intravitreal tissue plasminogen activator treatment of experimental vitreous hemorrhage. Arch Ophthalmol 1989; 107: 891–894.

    Article  CAS  PubMed  Google Scholar 

  12. Johnson RN, Olsen K, Hernandez E. Tissue plasminogen activator treatment of postoperative intraocular fibrin. Ophthalmology 1988; 95: 592–596.

    Article  CAS  PubMed  Google Scholar 

  13. Kohno T, Sorgente N, Ishibashi T et al. Immunofluorescent studies of fibronectin and laminin in the human eye. Invest Ophthalmol Vis Sci 1987; 28: 506–514.

    CAS  PubMed  Google Scholar 

  14. Lambrou FH, Snyder RW, Williams GA et al. Treatment of experimental intravitreal fibrin with tissue plasminogen activator. Am J Ophthalmol 1987; 104: 619–623.

    CAS  PubMed  Google Scholar 

  15. Lambrou FH, Snyder RW, Williams GA. Use of tissue plasminogen activator in experimental hyphema. Arch Ophthalmol 1987; 105: 995–997.

    Article  CAS  PubMed  Google Scholar 

  16. Liotta LA, Goldfarb RH, Terranova VP. Cleavage of laminin by thrombin and plasmin: Alpha thrombin selectively cleaves the beta chain of laminin. Thromb Res 1981; 21: 663–673.

    Article  CAS  PubMed  Google Scholar 

  17. Matsuo O, Rijken DC, Collen D. Comparison of the relative fibrinogenolytic, fibrinolytic and thrombolytic properties of tissue plasminogen activator and urokinasein vitro. Thromb Haemost 1981; 45: 225–229.

    CAS  PubMed  Google Scholar 

  18. Mosher D, Proctor R, Grossman J. Fibronectin: Role in inflammation. In: Weissman G ed. Advances in Inflammation Research. Vol. 2. New York: Raven Press, 1981.

    Google Scholar 

  19. Oncel M, Peyman GA, Khoobehi B. Tissue plasminogen activator in the treatment of experimental retinal vein occlusion. Retina 1989; 9: 1–7.

    Article  CAS  PubMed  Google Scholar 

  20. O'Rourke J, Moore M, Kreutzer DL. Regulation of anterior chamber fibrinolysis. Curr Eye Res 1985; 4: 569–578.

    Article  PubMed  Google Scholar 

  21. Pennica D, Holmes WE, Kohr WJ et al. Cloning and expression of human tissue-type plasminogen activator cDNA in E. coli. Nature 1983; 301: 214–221.

    Article  CAS  PubMed  Google Scholar 

  22. Peyman GA, Herbst R. Bacterial endophthalmitis: Treatment with intraocular injection of gentamicin and dexa-methasone. Arch Ophthalmol 1974; 91: 416–418.

    Article  CAS  PubMed  Google Scholar 

  23. Peyman GA, Paque JT, Meisels HI et al. Postoperative endophthalmitis: A comparison of methods for treatment and prophylaxis with gentamicin. Ophthalmic Surg 1975; 6: 45–55.

    CAS  PubMed  Google Scholar 

  24. Snyder RW, Lambrou FH, Williams GA. Intraocular fibrinolysis with recombinant human tissue plasminogen activator. Arch Ophthalmol 1987; 105: 1277–1280.

    Article  CAS  PubMed  Google Scholar 

  25. Sramek SJ, Wallow IHL, Bindley C et al. Fibronectin distribution in the rat eye: An immunohistochemical study. Invest Ophthalmol Vis Sci 1987; 28: 500–505.

    CAS  PubMed  Google Scholar 

  26. Talley AR, D'Amico DJ, Talamo J et al. The role of vitrectomy in the treatment of postoperative bacterial endophthalmitis: An experimental study. Arch Ophthalmol 1987; 105: 1699–1702.

    Article  CAS  PubMed  Google Scholar 

  27. Van de Werf F, Ludbrook PA, Bergmann SR et al. Clot selective coronary thrombolysis with tissue-type plasminogen activator in patients with evolving myocardial infarction. New Engl J Med 1984; 310: 609–613.

    Article  PubMed  Google Scholar 

  28. Vine AK, Maguire PT, Martonyi C et al. Recombinant tissue plasminogen activator to lyse experimentally induced retinal arterial thrombi. Am J Ophthalmol 1988; 105: 266–272.

    CAS  PubMed  Google Scholar 

  29. Weimar W, Stibbe J, van Seyen AJ et al. Specific lysis of an iliofemoral thrombus by administration of extrinsic (tissue-type) plasminogen activator. Lancet 1981; 2: 1018–1020.

    Article  CAS  PubMed  Google Scholar 

  30. Williams GA, Lambrou FH, Jaffe GA et al. Treatment of postvitrectomy fibrin formation with intraocular tissue plasminogen activator. Arch Ophthalmol 1988; 106: 1055–1058.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Baziuk, N., Fang, T., Peyman, G.A. et al. Intravitreal recombinant tissue plasminogen activator in the treatment of experimentally induced bacterial endophthalmitis. Int Ophthalmol 15, 79–86 (1991). https://doi.org/10.1007/BF01046426

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01046426

Key words

Navigation