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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. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
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.
In this case series, we report on seven patients who received intravenous fibrinolysis within the first 4.5 hours after symptom onset.
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.
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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