September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Intravenous fibrinolysis in acute non-arteritic central retinal artery occlusion - revisited
Author Affiliations & Notes
  • Martin Stephan Spitzer
    Tuebingen University Eye Center, Tuebingen, Germany
  • Sven Poli
    Department of Neurology, University Hospital Tuebingen, Tuebingen, Germany
  • Florian Haertig
    Department of Neurology, University Hospital Tuebingen, Tuebingen, Germany
  • Nicolas Feltgen
    Department of Ophthalmology, University of Goettingen, Goettingen, Germany
  • Max Schultheiss
    Tuebingen University Eye Center, Tuebingen, Germany
  • Footnotes
    Commercial Relationships   Martin Spitzer, None; Sven Poli, None; Florian Haertig, None; Nicolas Feltgen, None; Max Schultheiss, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 5352. doi:
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    • Get Citation

      Martin Stephan Spitzer, Sven Poli, Florian Haertig, Nicolas Feltgen, Max Schultheiss; Intravenous fibrinolysis in acute non-arteritic central retinal artery occlusion - revisited. Invest. Ophthalmol. Vis. Sci. 2016;57(12):5352.

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

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Abstract

Purpose : Central retinal artery occlusion (CRAO) is an ophthalmologic emergency that often results in severe loss of vision or even blindness. However, no evidence-based therapy exists for the treatment of non-arteritic CRAO. In previous prospective randomized trials (intra-arterial and intravenous fibrinolysis) so far only one patient has been treated within the first 4.5 hours after symptom onset.

Methods : In this case series, we report on seven patients who received intravenous fibrinolysis within the first 4.5 hours after symptom onset.

Results : The mean Log(MAR) visual acuity increased from 2.5 (“hand motion”) (SD ± 0.23) to 1.1 (“20/250”)(SD ± 0.76). Furthermore, the visual field improved dramatically in four out of seven patients. No adverse events were observed in this case series. The outcome was far superior compared to the results of previous trials in which lysis could not be performed so promptly.

Conclusions : Intravenous fibrinolysis within the first 4.5 hours after symptom onset could be an effective and safe treatment in CRAO. Thus, a new prospective, randomized, placebo controlled trial is needed which only enrolls CRAO patients with a very recent onset.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

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