Safety and Efficacy of Selective Intra-arterial Thrombolysis for Central Retinal Artery Occlusion
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Purpose: The purpose of this study was to determine the efficacy and safety of selective intra-arterial thrombolysis in patientswith central retinal artery occlusion (CRAO). Methods: Medical records for 44 eyes of 44 patients diagnosed with acute non-arteritic CRAO and thrombolysis betweenOctober 2010 and February 2019 were analyzed retrospectively. Based on visual acuity, fundoscopic findings, and fluoresceinangiography, the patients were classified into three stages: incomplete, subtotal, and total. The perfusion state using thebest-corrected visual acuity (BCVA), arm to retina time, and arteriovenous passage times, after 1 month, 6 months, and at thefinal visit after the procedure, were compared with baseline readings. Results: Improvement of visual acuity was confirmed in 31 out of 44 patients (70.45%). The mean BCVA of 44 patientschanged from 1.65 ± 0.78 logarithmic minimum angle of resolution (logMAR) at the first visit to 1.18 ± 0.91 logMAR at the lastvisit (p = 0.114). The BCVA according to CRAO stage was 0.08 ± 0.11 logMAR for the incomplete stage at the first visit, 0.06± 0.05 logMAR (p = 0.933) 1 month after the procedure, and 0.05 ± 0.07 logMAR (p = 0.933) at the last visit. In the subtotalstage, the results were 1.81 ± 0.54 logMAR at the first visit, 1.63 ± 0.76 logMAR (p = 0.035) 1 month after the procedure, and1.36 ± 0.85 logMAR (p = 0.014) at the last visit. For the total stage of BCVA, the result at the first visit was 2.36 ± 0.25 logMAR,and it was 2.30 ± 0.30 logMAR (p = 0.510) 1 month after the procedure, and 2.42 ± 0.30 logMAR (p = 0.642) at the last visit. Reperfusion was observed in 40 patients out of the 44 (90.91%). Conclusions: Selective intra-arterial thrombolysis can be helpful in patients with subtotal CRAO in terms of visual improvementand retinal arterial reperfusion.
Abstract
Purpose: The purpose of this study was to determine the efficacy and safety of selective intra-arterial thrombolysis in patientswith central retinal artery occlusion (CRAO). Methods: Medical records for 44 eyes of 44 patients diagnosed with acute non-arteritic CRAO and thrombolysis betweenOctober 2010 and February 2019 were analyzed retrospectively. Based on visual acuity, fundoscopic findings, and fluoresceinangiography, the patients were classified into three stages: incomplete, subtotal, and total. The perfusion state using thebest-corrected visual acuity (BCVA), arm to retina time, and arteriovenous passage times, after 1 month, 6 months, and at thefinal visit after the procedure, were compared with baseline readings. Results: Improvement of visual acuity was confirmed in 31 out of 44 patients (70.45%). The mean BCVA of 44 patientschanged from 1.65 ± 0.78 logarithmic minimum angle of resolution (logMAR) at the first visit to 1.18 ± 0.91 logMAR at the lastvisit (p = 0.114). The BCVA according to CRAO stage was 0.08 ± 0.11 logMAR for the incomplete stage at the first visit, 0.06± 0.05 logMAR (p = 0.933) 1 month after the procedure, and 0.05 ± 0.07 logMAR (p = 0.933) at the last visit. In the subtotalstage, the results were 1.81 ± 0.54 logMAR at the first visit, 1.63 ± 0.76 logMAR (p = 0.035) 1 month after the procedure, and1.36 ± 0.85 logMAR (p = 0.014) at the last visit. For the total stage of BCVA, the result at the first visit was 2.36 ± 0.25 logMAR,and it was 2.30 ± 0.30 logMAR (p = 0.510) 1 month after the procedure, and 2.42 ± 0.30 logMAR (p = 0.642) at the last visit. Reperfusion was observed in 40 patients out of the 44 (90.91%). Conclusions: Selective intra-arterial thrombolysis can be helpful in patients with subtotal CRAO in terms of visual improvementand retinal arterial reperfusion.
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