[Front-loading rt PA thrombolytic therapy in central or venous branch occlusions of the retina].
Although central retinal vein occlusion and branch retinal vein occlusion are among the most common vascular disorders affecting the retina, there is a great deal of confusion about their management. In view of the histopathological features of ischemic retinal vein occlusions, the use of fibrinolytic agents such as rt-PA (recombinant tissue-plasminogen activator) appears to be the most promising therapeutic approach.


METHODS
In nine patients with ischemic retinal vein occlusion, 50 mg of rt-PA were given i.v. over a period of 60 min. Simultaneously, heparin was infused at 1200 U/h. The i.v. heparinization was continued over a period of 8 days.


RESULTS
The clinical course was assessed by documenting visual acuity, fluorescein angiographies and fundal examinations. Additionally, several coagulation parameters were measured. No hemorrhagic complications were observed. In 8 cases, an improvement of visual acuity and retinal perfusion was noted.


CONCLUSIONS
Based on our results, we would recommend the fibrinolytic therapy with rt-PA and heparin in the treatment of ischemic retinal vein occlusions.
Steinkamp
G W
GW
Zentrum Augenheilkunde, Universitäts-Klinikum Frankfurt/Main.
Hattenbach
L O
LO
Scharrer
I
I
Ohrloff
C
C
D000328:Adult; D000368:Aged; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D011994:Recombinant Proteins / Q000008:administration & dosage; D012170:Retinal Vein Occlusion / Q000188:drug therapy*; D015912:Thrombolytic Therapy; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*
D011994:Recombinant Proteins; D006493:Heparin; D010959:Tissue Plasminogen Activator
Front-loading-rt-PA-Lysetherapie bei Zentral- oder Venenastverschlüssen der Netzhaut.