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Research ArticleINTERVENTIONAL

Prognosis of Central Retinal Artery Occlusion: Local Intraarterial Fibrinolysis versus Conservative Treatment

Dieter P. Schmidt, Jürgen Schulte-Mönting and Martin Schumacher
American Journal of Neuroradiology September 2002, 23 (8) 1301-1307;
Dieter P. Schmidt
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Jürgen Schulte-Mönting
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Martin Schumacher
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Abstract

BACKGROUND AND PURPOSE: Local intraarterial fibrinolysis (LIF) is one of several methods used in treating central retinal artery occlusion (CRAO). We investigated whether LIF is more effective than conservative methods in the treatment of CRAO.

METHODS: In this retrospective study, a total of 178 patients (125 men and 53 women) with CRAO were treated at the Eye Hospital of the University of Freiburg from 1980 to 2000. The average age of the patients was 66.8 years (SD, 12 years). In group I, 116 patients were treated conservatively by anterior chamber paracentesis, massage of the globe, isovolemic hemodilution, acetazolamide, Pentoxifyllin, acetylsalicylic acid, and reduction of arterial hypertension. Some combination but not all of the mentioned conservative methods were used in the conservatively treated patients. In group II, 62 patients receiving LIF received local injection of urokinase or recombinant tissue plasminogen activator into the proximal part of the ophthalmic artery. In case of ipsilateral carotid artery occlusion or high grade stenosis (14 of 62 patients), the thrombolytic agent was administered into the internal maxillary artery.

RESULTS: Among 178 patients, the CRAO was subtotal in 130 (73.0%), incomplete in 39 (21.9%), and total in nine (5.1%). Statistical calculations showed a significantly better visual acuity in group II patients, who were treated with LIF, in comparison with group I patients, who were treated conservatively (P = .0022).

CONCLUSION: For patients with CRAO, LIF is superior to conservative treatment.

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American Journal of Neuroradiology: 23 (8)
American Journal of Neuroradiology
Vol. 23, Issue 8
1 Sep 2002
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Prognosis of Central Retinal Artery Occlusion: Local Intraarterial Fibrinolysis versus Conservative Treatment
Dieter P. Schmidt, Jürgen Schulte-Mönting, Martin Schumacher
American Journal of Neuroradiology Sep 2002, 23 (8) 1301-1307;

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Prognosis of Central Retinal Artery Occlusion: Local Intraarterial Fibrinolysis versus Conservative Treatment
Dieter P. Schmidt, Jürgen Schulte-Mönting, Martin Schumacher
American Journal of Neuroradiology Sep 2002, 23 (8) 1301-1307;
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  • Efficacy and Safety of Intra-Arterial Thrombolysis in Central Retinal Artery Occlusion
  • Systemic Prostaglandin E1 to Treat Acute Central Retinal Artery Occlusion
  • Efficacy of Intravenous Tissue-Type Plasminogen Activator in Central Retinal Artery Occlusion: Report From a Randomized, Controlled Trial
  • Local Intraarterial Fibrinolysis Administered in Aliquots for the Treatment of Central Retinal Artery Occlusion: The Johns Hopkins Hospital Experience
  • Intra-arterial thrombolysis for central retinal artery occlusion: a systematic review
  • Intra-arterial thrombolysis for central retinal artery occlusion
  • Activation of the Mitochondrial Apoptotic Pathway in a Rat Model of Central Retinal Artery Occlusion
  • Comparison of intra-arterial thrombolysis with conventional treatment in patients with acute central retinal artery occlusion
  • Thrombolysis for central retinal artery occlusion
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