Intra-arterial thrombolysis for retinal artery occlusion: the Calgary experience.
INTRODUCTION: Retinal artery occlusion represents a medical emergency with poor prognosis for visual recovery. Spontaneous improvement is estimated to occur in less than 15% of central retinal artery occlusion (CRAO) cases and conventional treatments have provided only limited benefit. Intra-arteri...
| Main Authors: | , , , , , , , , |
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| Format: | Journal article |
| Language: | English |
| Published: |
2005
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| _version_ | 1826303212879085568 |
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| author | Pettersen, J Hill, MD Demchuk, A Morrish, W Hudon, M Hu, W Wong, J Barber, P Buchan, A |
| author_facet | Pettersen, J Hill, MD Demchuk, A Morrish, W Hudon, M Hu, W Wong, J Barber, P Buchan, A |
| author_sort | Pettersen, J |
| collection | OXFORD |
| description | INTRODUCTION: Retinal artery occlusion represents a medical emergency with poor prognosis for visual recovery. Spontaneous improvement is estimated to occur in less than 15% of central retinal artery occlusion (CRAO) cases and conventional treatments have provided only limited benefit. Intra-arterial thrombolysis has been reported as a potentially efficacious and safe treatment. METHODS: We performed a retrospective chart review of all retinal artery occlusion cases treated with intra-arterial recombinant tissue-type plasminogen activator (rtPA) from January 1998 to May 2004. Patients received Goldmann perimetry visual field testing at a variable interval following the procedure (2 days-2.5 years). Visual acuity (VA) was re-assessed in May 2004. RESULTS: Eight cases (59-77 years) were treated for CRAO, 6-18 hours post-onset with intra-arterial rtPA (10-20 mg over 15-60 minutes); one case of branch occlusion (BRAO) was treated with 30 mg rtPA over 75 minutes, 12 hours post-onset. Among the six patients with CRAO assessed in clinic, three experienced improvement in VA by two or more gradations (Snellen lines); three improved by one gradation. However, none achieved a final VA better than 20/300. The case of branch occlusion improved to a VA of 20/20. All patients had residual monocular field defects. CONCLUSIONS: Our findings reveal a limited benefit for intra-arterial tPA compared to the rate of spontaneous improvement and conventional forms of therapy for retinal artery occlusion. |
| first_indexed | 2024-03-07T05:59:14Z |
| format | Journal article |
| id | oxford-uuid:eb993dbe-d9c7-4c3b-81ef-5bc58a827a88 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T05:59:14Z |
| publishDate | 2005 |
| record_format | dspace |
| spelling | oxford-uuid:eb993dbe-d9c7-4c3b-81ef-5bc58a827a882022-03-27T11:10:54ZIntra-arterial thrombolysis for retinal artery occlusion: the Calgary experience.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:eb993dbe-d9c7-4c3b-81ef-5bc58a827a88EnglishSymplectic Elements at Oxford2005Pettersen, JHill, MDDemchuk, AMorrish, WHudon, MHu, WWong, JBarber, PBuchan, A INTRODUCTION: Retinal artery occlusion represents a medical emergency with poor prognosis for visual recovery. Spontaneous improvement is estimated to occur in less than 15% of central retinal artery occlusion (CRAO) cases and conventional treatments have provided only limited benefit. Intra-arterial thrombolysis has been reported as a potentially efficacious and safe treatment. METHODS: We performed a retrospective chart review of all retinal artery occlusion cases treated with intra-arterial recombinant tissue-type plasminogen activator (rtPA) from January 1998 to May 2004. Patients received Goldmann perimetry visual field testing at a variable interval following the procedure (2 days-2.5 years). Visual acuity (VA) was re-assessed in May 2004. RESULTS: Eight cases (59-77 years) were treated for CRAO, 6-18 hours post-onset with intra-arterial rtPA (10-20 mg over 15-60 minutes); one case of branch occlusion (BRAO) was treated with 30 mg rtPA over 75 minutes, 12 hours post-onset. Among the six patients with CRAO assessed in clinic, three experienced improvement in VA by two or more gradations (Snellen lines); three improved by one gradation. However, none achieved a final VA better than 20/300. The case of branch occlusion improved to a VA of 20/20. All patients had residual monocular field defects. CONCLUSIONS: Our findings reveal a limited benefit for intra-arterial tPA compared to the rate of spontaneous improvement and conventional forms of therapy for retinal artery occlusion. |
| spellingShingle | Pettersen, J Hill, MD Demchuk, A Morrish, W Hudon, M Hu, W Wong, J Barber, P Buchan, A Intra-arterial thrombolysis for retinal artery occlusion: the Calgary experience. |
| title | Intra-arterial thrombolysis for retinal artery occlusion: the Calgary experience. |
| title_full | Intra-arterial thrombolysis for retinal artery occlusion: the Calgary experience. |
| title_fullStr | Intra-arterial thrombolysis for retinal artery occlusion: the Calgary experience. |
| title_full_unstemmed | Intra-arterial thrombolysis for retinal artery occlusion: the Calgary experience. |
| title_short | Intra-arterial thrombolysis for retinal artery occlusion: the Calgary experience. |
| title_sort | intra arterial thrombolysis for retinal artery occlusion the calgary experience |
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