Efficacy and toxic effect associated with subretinal tissue plasminogen activator injection in treating submacular hemorrhage

Dear Editor,We write to present a case of a successful surgical management of submacular hemorrhage(SMH)by subretinal injection of 40μg recombinant tissue plasminogen activator(r-tPA),finding a possible toxic effect associated with fundus atrophic changes.This study has been performed in accordance with the Declaration of Helsinki and was approved by the Ethics Committee of Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine.Written informed consent was obtained from the patient.