- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin 300384, China;
Tissue plasminogen activator (t-PA), a serine protease capable of promoting fibrin degradation and thrombus dissolution, plays a pivotal role in the management of cardiovascular and cerebrovascular diseases. In recent years, its ophthalmic applications have expanded significantly. Intravitreal administration of t-PA demonstrates efficacy in inducing posterior vitreous detachment, thereby enhancing surgical success rates. Combined application with vitrectomy markedly improves outcomes in subretinal hemorrhage management. Systemic thrombolysis via intravenous or intra-arterial routes effectively alleviates central retinal artery occlusion, while suprachoroidal injection facilitates resolution of suprachoroidal hemorrhage. Notably, the synergistic effect of subretinal co-administration with anti-vascular endothelial growth factor agents enhances anti-angiogenic efficacy, offering novel therapeutic strategies for ocular neovascular disorders. In the future, it is necessary to further clarify the best indication of t-PA, improve the treatment scheme, and explore the combined application with other treatment methods to promote the innovation of ophthalmic treatment.
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