[Minimally invasive therapy for clinically complete central retinal artery occlusion--results and meta-analysis of literature].
BACKGROUND
Goal of our study was the comparison of the efficacy of various minimal invasive therapeutic regimens for clinically complete central retinal artery occlusion (CRAO) and the comparison with the literature.


METHODS
In a retrospective study 93 patients treated for CRAO during the period 1994-1998 were identified. 65 of these patients with clinically complete occlusion without a cilioretinal artery were included in the study. Analysis focused on the results of different therapies and the duration of visual impairment till starting treatment.


RESULTS
The following therapies were used: acetazolamide (65%), aspirin (60%), bulbus massage (45%), hemodilution (34%), oral pentoxifylline (28%), topical beta blockers (9%), paracentesis (8%), heparin (6%). In 15% of all cases an improvement of at least 3 visual acuity gradations was achieved. No significant positive influence of any treatment method could be identified. Also, a correlation between duration of visual impairment and final visual acuity could not be shown. In the literature very different criteria for inclusion of patients to the studies and for visual acuity improvement are found. When applying comparable criteria to ours most studies show similar results for the therapies listed above as well as for paracentesis and the use of carbogen (95% O2 and 5% CO2).


CONCLUSIONS
The minimal invasive treatments given above do only improve natural course of CRAO in occasional cases. Thus a therapy (-combination) should be chosen, which is adapted to the individual risk factors and is exposing the patient to a low risk by therapy itself.
Neubauer
A S
AS
Augenklinik der Ludwig-Maximilians-Universität München. amueller@ak-i.med.uni-muenchen.de
Mueller
A J
AJ
Schriever
S
S
Grüterich
M
M
Ulbig
M
M
Kampik
A
A
D000086:Acetazolamide / Q000627:therapeutic use; D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001241:Aspirin / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006438:Hemodilution; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008405:Massage; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D019152:Paracentesis; D010431:Pentoxifylline / Q000627:therapeutic use; D015356:Retinal Artery Occlusion / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D015912:Thrombolytic Therapy; D016896:Treatment Outcome; D014792:Visual Acuity
D000319:Adrenergic beta-Antagonists; D005343:Fibrinolytic Agents; D006493:Heparin; D000086:Acetazolamide; D001241:Aspirin; D010431:Pentoxifylline