title: Intravenous thrombolysis with low-dose recombinant tissue plasminogen activator in central retinal artery occlusion.
abstract: OBJECTIVE
  To evaluate the beneficial effect of intravenous thrombolysis aiming at rapid restoration of blood flow during the early hours of a central retinal artery occlusion (CRAO).
  
  
  METHODS
  Interventional case series.
  
  
  METHODS
  In the present study, we prospectively evaluated the visual outcome after thrombolytic treatment with low-dose (50 mg) rt-PA (recombinant tissue plasminogen activator) and concomitant intravenous heparinization in patients with acute CRAO, best-corrected visual acuity (BCVA) < or = 20/100, and onset of symptoms within 12 hours prior to treatment.
  
  
  RESULTS
  Twenty-eight patients (28 eyes) were included in this study. Final visual acuity was improved three or more lines in nine eyes (32%), stable in 18 (64%), and worse in one eye. Time to treatment < or = 6.5 hours was associated with a better gain of lines of vision (P = .004). Seven of 17 eyes (41%) that received thrombolytic treatment within the first 6.5 hours achieved a final BCVA > or = 20/50, compared to none in the subgroup of patients with onset to treatment >6.5 hours (P = .023). We observed no serious adverse events.
  
  
  CONCLUSIONS
  Our findings indicate that thrombolytic treatment with intravenous low-dose rt-PA is of value for an improved visual recovery in patients with acute CRAO, if administered within the first 6.5 hours after the onset of symptoms.
authors: Klinik für Augenheilkunde, Klinikum der Johann Wolfgang Goethe Universität, Frankfurt am Main, Germany. hattenbach.lo@klilu.de
authors: Lars-Olof
authors: LO
authors: Hattenbach
authors: Claudia
authors: C
authors: Kuhli-Hattenbach
authors: Inge
authors: I
authors: Scharrer
authors: Holger
authors: H
authors: Baatz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011994:Recombinant Proteins / Q000008:administration & dosage / Q000627:therapeutic use; D012039:Regional Blood Flow / Q000187:drug effects; D012161:Retinal Artery / Q000503:physiopathology; D015356:Retinal Artery Occlusion / Q000188:drug therapy* / Q000503:physiopathology*; D015912:Thrombolytic Therapy; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage* / Q000627:therapeutic use; D016896:Treatment Outcome; D014792:Visual Acuity / Q000187:drug effects*
chemical_list: D005343:Fibrinolytic Agents; D011994:Recombinant Proteins; D010959:Tissue Plasminogen Activator