Intravenous thrombolysis with low-dose recombinant tissue plasminogen activator in central retinal artery occlusion

American Journal of Ophthalmology
Lars-Olof HattenbachHolger Baatz

Abstract

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). Interventional case series. 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. 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. 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 administe...Continue Reading

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