Central retinal artery occlusion is known to have a poor natural outcome, and also conventional therapeutic procedures e.g. paracentesis, hemodilution or local massage show unfavorable results. As in intraarterial fibrinolytic therapy in cerebral vessels, we also applied this method to the territory of the ophthalmic artery in 6 patients with occlusion of the central retinal artery. The fibrinolysis was done with a microcatheter superselectively, placed in the proximal part of the ophthalmic artery. The amount of urokinase varied from 200,000 to 900,000 IU, diluted in saline solution.
We describe the results of early hyperbaric oxygenation combined with nifedipine treatment for central retinal artery occlusion, and explain the results pathophysiologically. We report four cases in which hyperbaric oxygenation therapy was applied in combination with nifedipine, eyeball massage, and glycerol for the treatment of central retinal artery occlusion.
Particularly in patients over 40 years of age, disturbances of perfusion at the optic nerve head and retina are a frequent cause of acute visual acuity loss. As the most important disease entities, we must distinguish between ischemic optic neuropathy and arterial and venous perfusion disturbances. The prognosis with regard to visual acuity is, at any rate, serious: a considerable, persistent loss of vision must be expected. Unfortunately, at present there is no therapy available which could normalize perfusion quickly enough.
BACKGROUND: Goal of our study was the comparison of the efficacy of various minimal invasive therapeutic regimens for clinically complete central retinal artery occlusion (CRAO) and the comparison with the literature. PATIENTS AND METHODS: In a retrospective study 93 patients treated for CRAO during the period 1994-1998 were identified. 65 of these patients with clinically complete occlusion without a cilioretinal artery were included in the study. Analysis focused on the results of different therapies and the duration of visual impairment till starting treatment.
Der Ophthalmologe: Zeitschrift Der Deutschen Ophthalmologischen Gesellschaft
Retinal artery occlusion (RAO) is an ophthalmological emergency that causes a major decrease of visual parameters in most of the cases. Purpose of this pilot study was to evaluate the effect of adjunctive hyperbaric oxygen therapy (HBO) on visual acuity (VA). PATIENTS AND METHODS: Patients with acute central or branch artery occlusion (CRAO/BRAO) consecutively admitted to our hospital were offered adjunctive HBO. Standard therapy consisted of ocular massage for 3 minutes, paracentesis and intravenous acetazolamide. HBO (3 x 30 minutes at 240 kPa) was applied t.i.d. on the first day, b.i.d.
PURPOSE: To report a case of retinal and choroidal vascular occlusion occurring as a complication after posterior sub-Tenon triamcinolone injection for treatment of uveitic cystoid macular edema. DESIGN: Interventional case report. METHODS: Retrospective study. A 32-year-old woman with uveitis and cystoid macular edema underwent a right posterior sub-Tenon injection of triamcinolone (40 mg/ml, 1 ml total) through a superotemporal approach after topical anesthesia.
BACKGROUND: Central retinal artery occlusion causes severe loss of vision. Treatment trials include massage of the globe, paracentesis, antiglaucomatous eye drops, haemodilution or lysis therapy, which in individual cases did improve the visual outcome, although in general the prognosis remains poor. In this study we applied hyperbaric oxygenation treatment additionally to haemodilution to overcome retinal ischaemia until spontaneous recanalisation of the central retinal artery occurs.
Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Für Klinische Und Experimentelle Ophthalmologie
BACKGROUND: The natural course of central retinal artery occlusion (CRAO) often leads to legal blindness in the affected eye. To date, none of the conservative therapies had proven effective in retrospective studies. In 1991, a new minimally invasive therapy was started in patients with an acute CRAO. This therapy, namely, local intra-arterial fibrinolysis, is comparable to the minimally invasive therapy in patients with an acute ischemic stroke. In pilot studies, it showed promising results in comparison with conservative treatments.
PURPOSE OF REVIEW: Numerous therapeutic options have been suggested for the treatment of central retinal artery occlusion (CRAO) such as ocular massage, anterior chamber paracentesis, physical exercise, and medication-induced reduction of intraocular pressure. Because of the lack of a proven effective treatment for CRAO, there has been a strong effort to develop alternative therapies. Recently, thrombolytic therapy has been suggested as a viable therapy for CRAO. The aim of this review is to provide an update on the progress of thrombolytic therapy for CRAO.
BACKGROUND: To investigate the visual outcomes in acute central retinal artery occlusion (CRAO) with current standard therapy at two university teaching hospitals. METHODS: Retrospective analysis of two cohorts of CRAO patients from John Hopkins Hospital (JHH; USA), and Flinders Medical Centre (FMC; Australia), treated with current standard therapy. The outcome measures were visual acuity, and subsequent ocular and systemic ischaemic events. RESULTS: The mean follow-up period was 11.2 +/- 13.1 months in the JHH cohort and 35.4 +/- 34.9 months in the FMC cohort.