J Korean Ophthalmol Soc.  2020 Dec;61(12):1442-1449. 10.3341/jkos.2020.61.12.1442.

The Effect of Intra-arterial Thrombolysis in Retinal Artery Occlusion: Case Series and Literature Review

• Cho SI
• Kim JH
• Cho NC

• KMID: 2511285
• DOI: http://doi.org/10.3341/jkos.2020.61.12.1442

Abstract

Purpose
We performed intra-arterial thrombolysis within 6 hours of presentation in Korean patients with acute retinal artery occlusion. The treatment outcomes of our patients were compared with those from a literature review of this procedure.
Methods
Visual acuity, intraocular pressure, fundus photo, and fluorescein angiography were examined in five Korean patients who ultimately underwent intra-arterial thrombolysis due to central retinal artery occlusion. The visual acuity of patients was evaluated after the procedure. The treatment outcomes of our patients were compared with those presented in six foreign intra-arterial thrombolysis studies with respect to age, sex, and visual acuity before and after intra-arterial thrombolysis.
Results
In our five cases (three males and two females), the average age was 63.4 years and the average time to the procedure of intra-arterial thrombolysis was 4.8 hours. In the five cases, the visual acuity before intra-arterial thrombolysis were hand movements, 0.1, finger counting at 30 cm, hand movements, and 0.08. Visual acuity after intra-arterial thrombolysis were 0.9, 0.5, finger counting at 30 cm, 0.7, and 1.2. The average age of patients in the six studies from the literature was 60 years, and the most common visual acuity before intra-arterial thrombolysis was light perception and hand movements. A slight improvement in visual acuity (>0 to 0.1) was common in most of the studies; however, three studies showed a partial recovery (from 0.2 to 0.4).
Conclusions
For retinal artery occlusion, intra-arterial thrombolysis within 6 hours should be considered as a treatment option.

Keyword

Golden hour; Intra-arterial thrombolysis; Retinal artery occlusion