Clinical research status and progress of central retinal artery occlusion / 中华眼底病杂志

Embolus occlusion in the retinal artery is the most common cause of central retinal artery occlusion (CRAO),while hypertension is the most common risk factor of CRAO,and ipsilateral carotid artery stenosis is the most significant risk factor in CRAO.Current clinical treatments include conservative treatments such as dilation of blood vessels and lowering the intraocular pressure (IOP),as well as aggressive treatments like intravenous thrombolysis and Nd∶YAG laser.Both thrombolysis and Nd∶YAG laser treatment can improve the visual acuity of CRAO patients,but because of its lack of randomized controlled trials,further clinical studies are needed to determine their efficacy and safety.CRAO patients may have vascular embolism at other sites in the body,and may cause different degrees of cardiovascular and cerebrovascular events.The probability of secondary ocular neovascularization following the occurrence of these events is 2.5％ to 31.6％.In addition to eye care,clinicians should also focus more on preventing cardiovascular and cerebrovascular events,and focus on the screening and active treatment of systemic risk factors to reduce the incidence and mortality of cardiovascular and cerebrovascular events.

Thrombolysis infusion via microcatheter treating central retinal artery occlusion / 中华眼底病杂志

Objective To investigate the therapeutic effects of thrombolysis infusion via microcatheter on the treatment of central retinal artery occlusion(CRAO). Methods Urokinase (UK) was directly infused via ophthalmic artery (OA) by microcatheter (6 patients) or via intravenous (7 patients) to dissolve the thrombus. The patency of the artery was evaluated by fundus fluorescein angiography (FFA), and the effect of fibrinolytic activity on the systemic changes was observed by blood biochemical examination simultaneously. Results In 6 patients in the microcatheter group, 5 had completely and 1 had partly reopened OA on the morrow of UK infusion with the patency rate of 83.33%, while in 7 patients in vein group, 3 completely reopened, 2 partly reopened and 2 obstructed OA were found with the patency rate of 42.86%. The difference between the two groups was significant. No obvious change of index of blood coagulation system was found in catheter group, which had great disparity compared with the vein group. Conclusion Urokinase infusion via microcatheter in CRAO has better therapeutic impact and smaller effect on systemic action.