Korean J Ophthalmol > Epub ahead of print
DOI: https://doi.org/10.3341/kjo.2020.0082    [Epub ahead of print]
Published online June 21, 2021.
The Safety and Efficacy of Selective Intra-arterial Thrombolysis for Central Retinal Artery Occlusion
Sang Jun Ko1, In Choel Shin1, Dae Won Kim2, Si Sung Choi3, Yun Sik Yang1
1Department of Ophthalmology, Wonkwang University College of Medicine, Iksan, Korea
2Department of Neurosurgery, Wonkwang University College of Medicine, Iksan, Korea
3Department of Radiology, Wonkwang University College of Medicine, Iksan, Korea
Correspondence:  Yun Sik Yang, Tel: +82 63 859 1370, Fax: +82 63 855 1801, 
Email: ysyang@wonkwang.ac.kr
Received: 15 June 2020   • Revised: 10 May 2021   • Accepted: 18 May 2021
Abstract
Purpose
The purpose of this study was to determine the efficacy and safety of selective Intra-Arterial Thrombolysis (IAT) in patients with Central Retinal Artery Occlusion (CRAO).
Methods
Medical records for 44 eyes of 44 patients diagnosed with acute non-arteritic CRAO and thrombolysis between October 2010 and February 2019 were analyzed retrospectively. Based on visual acuity, fundoscopic findings, and fluorescein angiography, the patients were classified into three stages: incomplete, subtotal, and total. The perfusion state using the best-corrected visual acuity (BCVA), arm to retina time, and arteriovenous passage times, after 1 month, 6 months, and at the final visit after the procedure, were compared with baseline readings.
Results
Improvement of visual acuity was confirmed in 31 out of 44 patients (70.45%). The mean BCVA of 44 patients changed from 1.65 ± 0.78 logMAR at the first visit to 1.18 ± 0.91 logMAR at the last visit (p = 0.114). The BCVA according to CRAO stage was 0.08 ± 0.11 logMAR for the incomplete stage at the first visit, 0.06 ± 0.05 logMAR (p = 0.933) 1 month after the procedure, and 0.05 ± 0.07 logMAR (p = 0.933) at the last visit. In the subtotal stage, the results were 1.81 ± 0.54 logMAR at the first visit, 1.63 ± 0.76 logMAR (p = 0.035) 1 month after the procedure, and 1.36 ± 0.85 logMAR (p=0.014) at the last visit. For the total stage of BCVA, the result at the first visit was 2.36 ± 0.25 logMAR, and it was 2.30 ± 0.30 logMAR (p=0.510) 1 month after the procedure, and 2.42 ± 0.30 logMAR (p = 0.642) at the last visit. Reperfusion was observed in 40 patients out of the 44 (90.91%).
Conclusions
Selective IAT can be helpful in patients with subtotal CRAO in terms of visual improvement and retinal arterial reperfusion.
Key Words: Central retinal artery occlusion, Intra-arterial thrombolysis, Retinal reperfusion, Visual acuity


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