April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Predictors of Prognosis and Treatment Outcome in Central Retinal Artery Occlusion: results of the randomized multicenter EAGLE trial
Author Affiliations & Notes
  • Bernd Junker
    University Eye Hospital, Hannover Medical School, Hannover, Germany
    Eye Center, Albert-Ludwigs-University Freiburg, Freiburg, Germany
  • Stefanie Pantenburg
    University Eye Hospital, University Hospital Göttingen, Göttingen, Germany
  • Josep Callizo
    University Eye Hospital, University Hospital Göttingen, Göttingen, Germany
  • Claudia Schmoor
    Clinical Trials Unit, Albert-Ludwigs-University Freiburg, Freiburg, Germany
  • Martin Schumacher
    Center of Neurology, Albert-Ludwigs-University Freiburg, Freiburg, Germany
  • Nicolas Feltgen
    University Eye Hospital, University Hospital Göttingen, Göttingen, Germany
  • Amelie Pielen
    University Eye Hospital, Hannover Medical School, Hannover, Germany
    Eye Center, Albert-Ludwigs-University Freiburg, Freiburg, Germany
  • Footnotes
    Commercial Relationships Bernd Junker, None; Stefanie Pantenburg, None; Josep Callizo, None; Claudia Schmoor, None; Martin Schumacher, None; Nicolas Feltgen, None; Amelie Pielen, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 684. doi:
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      Bernd Junker, Stefanie Pantenburg, Josep Callizo, Claudia Schmoor, Martin Schumacher, Nicolas Feltgen, Amelie Pielen, ; Predictors of Prognosis and Treatment Outcome in Central Retinal Artery Occlusion: results of the randomized multicenter EAGLE trial. Invest. Ophthalmol. Vis. Sci. 2014;55(13):684.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: The randomized EAGLE (the European Assessment Group for Lysis in the Eye) trial included 84 patients with persistent central retinal artery occlusion (CRAO). Treatment with intra-arterial fibrinolysis (LIF) showed a similar improvement of 4.4 visual lines compared to a conservative standard treatment (CST). Safety analysis in favor of CST led to study discontinuation. Our aim was to analyze patients’ risk factors to determine predictive and prognostic factors.

Methods: Post hoc statistical analysis of effects of risk factors on BCVA at baseline and month 1 (prognostic effect) and on the difference between outcome of CST and LIF (predictive effect).

Results: 72 of 84 EAGLE patients were included. Prognostic effect: Patients with chronic heart disease presented worse BCVA at baseline (p=0.0097). Patients with time from occlusion to treatment > 12 h showed a trend to less vision gain at month 1 (p=0.074). Predictive effect: Age (p=0.070 univariate, p=0.20 multivariate analysis) might be predictor of therapeutic outcome. There was a trend in favour of LIF vs. CST in young patients and CST vs. LIF in older patients.

Conclusions: Age, chronic heart disease and time from occlusion to treatment are potential risk factors in CRAO. Patients treated within 12 h are more likely to profit from LIF or CST treatment. Patients < 60 y without chronic heart disease might profit more from LIF than from CST. Therefore, LIF might still be a therapeutic option in a carefully selected minority of patients with acute CRAO.

Keywords: 464 clinical (human) or epidemiologic studies: risk factor assessment • 688 retina • 466 clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials  
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