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Bernd Junker, Stefanie Pantenburg, Josep Callizo, Claudia Schmoor, Martin Schumacher, Nicolas Feltgen, Amelie Pielen, EAGLE Study Group; 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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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.
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).
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.
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.
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