Local intra-arterial thrombolysis for acute central retinal artery occlusion / 中国脑血管病杂志

ABSTRACT

Objective: Exploring the effect and safety of local intra-arterial thrombolysis (LIT) on acute central retinal artery occlusion (CRAO). Methods: Retrospective data analysis of 49 consecutive CRAO patients was performed. The visual acuity was 3.0-4.7 in 51% patients, and less than 3.0 in 49%. The averaged visual acuity was 1.5 ± 0.1. All the patients were treated with urokinase perfusion through the ophthalmology artery within the first 6 hours after CRAO attack. Conventional treatment including intra-ocular pressure decreasing, microcirculation improvement, neuroprotection and anti-coagulation were conducted. The visual acuity was detected at the 2, 28 days and 6 months after thrombolysis, and field of visions was detected at 28 days and 6 months after thrombolysis. And the thrombolysis related complications were observed. The correlation of the visual outcome after thrombolysis with the patient's ages, the time thrombolysis when started, and the residual visual acuity at admission were calculated. The complication which was related to cerebral angiography and LIT was explored. Results: Improvement of visual function was achieved after thrombolysis. The averaged visual acuity was 4.2 ± 0.2, 4.4 ± 0.3, 4.6 ± 0.5 at the 2,28 days and 6 months after thrombolysis respectively. 24.5% patients regained visual acuity of > 4.8, and visual field deficit was less than 30% in 34.7% at 28 days. 6 months later, 36.7% patients regained visual acuity of > 4.8. Field deficit was less than 30% in 44.9% patients. The pretreatment residual visual acuity was the significant predictor of good recovery of visual acuity (r=0.292, P < 0.05). There was no ischemic attack and hemorrhagic complication which correlated with cerebral angiography and LIT. Conclusion: LIT is an effective and safe method for CRAO patients. The pretreatment residual visual acuity is the significant predictor of good outcome.