Intra-arterial thrombolysis for acute central retinal artery occlusion.
OBJECTIVE
In this study, we aimed at exploring the effect and safety of local intra-arterial thrombolysis on acute central retinal artery occlusion.


METHODS
Retrospective data analysis of 49 consecutive acute central retinal occlusion patients was performed. All the patients were treated with urokinase perfusion through the ophthalmology artery within the first 6 hours after central retinal artery occlusion attack. Conventional treatments including intra-ocular pressure decreasing, microcirculation improvement, neuroprotection and antiplatelet aggregation were conducted. The visual acuity (with International Snellen Chart) and field of vision were detected after thrombolysis. The complications and adverse events were observed.


RESULTS
Recanalization was found in 71% of patients. The visual acuity improvement was greater in the recanalization group (n=35) than in the non-recanalization group (n=14). The averaged visual acuity was 0.15+/-0.02, 0.25+/-0.03 and 0.4+/-0.05 after 2, 28 days and 6 months, respectively. Of the patients, 24.5% regained >0.6 of visual acuity, and the visual field deficit was less than 30% in 34.7% of patients after 28 days. Six months later, 36.7% patients regained visual acuity of >0.6, and the field deficit was less than 30% in 44.9% of patients. The difference between visual acuity in recanalization (0.6+/-0.04) and non-recanalization (0.002+/-0.0012) patients after 6 months after thrombolysis was significant (p>0.05).


CONCLUSIONS
Intra-arterial thrombolysis could obviously improve the short- and long-term visual function for patients with acute central retinal artery occlusion within 6 hours of symptom onset.
Zhang
X
X
Department of Ophthalmology, The Capital Medical University, Beijing, China.
Ji
X
X
Luo
Y
Y
Liu
D
D
Guo
L
L
Wu
H
H
Miao
Z
Z
Zhu
F
F
Jiao
L
L
Ding
Y
Y
Ling
F
F
D000208:Acute Disease; D000328:Adult; D000368:Aged; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005451:Fluorescein Angiography / Q000379:methods; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000379:methods; D007429:Intraocular Pressure / Q000187:drug effects; D008297:Male; D008833:Microcirculation / Q000187:drug effects; D008875:Middle Aged; D011379:Prognosis; D015356:Retinal Artery Occlusion / Q000188:drug therapy* / Q000503:physiopathology; D012189:Retrospective Studies; D013997:Time Factors; D014568:Urokinase-Type Plasminogen Activator / Q000008:administration & dosage / Q000627:therapeutic use*; D014792:Visual Acuity / Q000187:drug effects; D014794:Visual Fields / Q000187:drug effects
D005343:Fibrinolytic Agents; D014568:Urokinase-Type Plasminogen Activator