Document Detail


Intra-arterial thrombolysis for retinal artery occlusion: the Calgary experience.
MedLine Citation:
PMID:  16408583     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
J A Pettersen; M D Hill; A M Demchuk; W Morrish; M E Hudon; W Hu; J Wong; P A Barber; A M Buchan
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques     Volume:  32     ISSN:  0317-1671     ISO Abbreviation:  Can J Neurol Sci     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2006-01-13     Completed Date:  2006-02-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0415227     Medline TA:  Can J Neurol Sci     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  507-11     Citation Subset:  IM    
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Canada
Female
Humans
Male
Middle Aged
Perimetry
Prognosis
Retinal Artery Occlusion / diagnosis,  drug therapy*
Retrospective Studies
Thrombolytic Therapy*
Time Factors
Tissue Plasminogen Activator / therapeutic use*
Visual Acuity / physiology
Visual Fields
Chemical
Reg. No./Substance:
EC 3.4.21.68/Tissue Plasminogen Activator

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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