Value of local ophthalmic artery fibrinolysis in severe forms of central retinal vein occlusion
Vallée, J.N.; Aymard, A.; Paques, M.; Santiago, P.Y.; Gaudric, A.; Merland, J.J.
Journal de Radiologie 82(2): 137-144
2001
ISSN/ISBN: 0221-0363 PMID: 11428208 Document Number: 529683
To assess the value of selective ophthalmic artery thrombolysis as a treatment for central retinal vein occlusion (CRVO) for which no alternative therapy is available. Patients included in this study presented with recent severe non-ischemic CRVO. Urokinase (300,000 IU) was perfused for 40 minutes into the ophthalmic artery. Visual acuity, fundoscopy and retinal arteriovenous transit time were assessed during one year of follow-up. Five of the 13 patients treated experienced a marked improvement of vision (p = 0.05) and retinal perfusion within 24-48 hours, and exhibited progressive lesion regression at fundoscopy within 2-4 weeks. The clinical course of the 5 patients prior to treatment resembled that of combined central retinal artery and vein obstruction (CRAO/CRVO), which typically has a poor visual outcome. One patient relapsed 1 month after thrombolysis. No technical complications were observed. Although there was no control group, the short period between fibrinolysis and significant visual improvement combined with marked retinal perfusion improvement, suggests that local thrombolysis is beneficial for CRVO, especially recent CRAO/CRVO.