[Value of local ophthalmic artery fibrinolysis in severe forms of central retinal vein occlusion].
OBJECTIVE
To assess the value of selective ophthalmic artery thrombolysis as a treatment for central retinal vein occlusion (CRVO) for which no alternative therapy is available.


METHODS
Patients included in this study presented with recent severe non-ischemic CRVO. Urokinase (300,000 IU) was perfused for 40 minutes into the ophthalmic artery. Visual acuity, fundoscopy and retinal arteriovenous transit time were assessed during one year of follow-up.


RESULTS
Five of the 13 patients treated experienced a marked improvement of vision (p = 0.05) and retinal perfusion within 24-48 hours, and exhibited progressive lesion regression at fundoscopy within 2-4 weeks. The clinical course of the 5 patients prior to treatment resembled that of combined central retinal artery and vein obstruction (CRAO/CRVO), which typically has a poor visual outcome. One patient relapsed 1 month after thrombolysis. No technical complications were observed.


CONCLUSIONS
Although there was no control group, the short period between fibrinolysis and significant visual improvement combined with marked retinal perfusion improvement, suggests that local thrombolysis is beneficial for CRVO, especially recent CRAO/CRVO.
Vallée
J N
JN
Département de Neuroradiologie et d'Angiographie Thérapeutique, Service de Neuroradiologie Diagnostique et Interventionnelle Charcot, Pitié Salpêtrière, 47-83, boulevard de l'Hôpital 75651 Paris, France. jnvallee@excite.fr
Aymard
A
A
Paques
M
M
Santiago
P Y
PY
Gaudric
A
A
Merland
J J
JJ
D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction; D018450:Disease Progression; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000379:methods; D008297:Male; D008875:Middle Aged; D009880:Ophthalmic Artery; D009887:Ophthalmoscopy; D012008:Recurrence; D012170:Retinal Vein Occlusion / Q000175:diagnosis / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000379:methods*; D016896:Treatment Outcome; D014568:Urokinase-Type Plasminogen Activator / Q000627:therapeutic use*; D014792:Visual Acuity
D005343:Fibrinolytic Agents; D014568:Urokinase-Type Plasminogen Activator