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Benjamin Botsford, AILEE LAHAM, Gabrielle Bonhomme, Shashvat Desai, Tudor G Jovin, Andrew W Eller; Intra-arterial Thrombolysis for Central Retinal Artery Occlusion. Invest. Ophthalmol. Vis. Sci. 2018;59(9):5445. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To examine clinical outcomes of intra-arterial thrombolysis with tissue plasminogen activator (tPA) for treatment of central retinal artery occlusion.
Retrospective case series of patients who underwent intra-arterial thrombolysis with tissue plasminogen activator from 2008 to present. Visual acuity at initial presentation, first outpatient follow-up, 6 -month follow-up, as well as rates of complications were assessed.
15 patients (mean age 71 years) who underwent treatment with intra-arterial tPA were identified. Average time between presentation and administration of tPA was 5.75 hours (range 1.5 to 10). Mean presenting LogMAR visual acuity was 2.3 (Hand motion Snellen equivalent). Mean LogMAR visual acuity at first known follow-up (average 15 days in TPA group and 23 days in conservative group) and 6-month follow-up was 2.0 (CF at 2’) and 2.0 respectively. Mean change in visual acuity from initial presentation to first follow-up was -0.32 (P = 0.03) with 8 patients having clinically significant improvement in visual acuity (LogMAR ≥ 0.3). Mean change in visual acuity from initial presentation to 6-month follow-up was -0.41 (P = 0.02), with 10 patients having clinically significant improvement in visual acuity. 3 patients developed neovascular glaucoma requiring PRP. No adverse effects from TPA (intracerebral hemorrhage, venipuncture site hemorrhage) were noted in this series.
Intra-arterial thrombolysis may show utility in selective cases, with careful consideration of risk and benefits.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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