A PRELIMINARY STUDY OF SYSTEMIC TREATMENT FOR ACUTE CENTRAL RETINAL ARTERY OCCLUSION WITH HIGH-DOSE UROKINASE / 解放军医学杂志

ABSTRACT

To investigate the effectiveness and safety of systemic administration of high dose urokinase for acute central retinal artery occlusion (CRAO). 6 patients who had unilateral CRAO with symptoms lasting 6 hours to six days' (average, 3 7 days) received intravenous urokinase, 500,000U / day, with a total dose of 2,500,000U. Each urokinase delivery was followed by in travenous low molecular weight Dextran, 500ml / day, and Ginaton 87 5 mg / day, for 10 days. The treatment also included anterior chamber paracentesis, ocular massage, oral acetazolamide, sublingual isosorbide dinitrate, and inhalation of carbogen ( 95% oxygen, 5% carbon dioxide ). Visual acuity and ocular findings were recorded before and after treatment. Duration of follow up ranged from 4 to 12 months. After first intravaneous urokinase, visual acuity was slightly improved in five of the 6 patients, and no change in one patient. All 6 patients showed markedly improved vision at discharge, with vision better than 0 05. At the final visit, visual acuity reached 0 1 in all the 6 patients, and in four patients visual acuity was improved to 0 2 or better, two patients had vision recovered even to 1 2 and 1 5, respectively. During treatment no serious complications were noticed. These results indicate that systemic treatment for acute central retinal artery occlusion with high dose urokinase could help reestablish retinal circulation and improve vision.