Butz B, Strotzer M, Manke C, Roider J, Link J, Lenhart M
Department of Radiology, University of Regensburg Hospital, Regensburg, Germany.
Acta Radiol. 2003 Nov;44(6):680-4. doi: 10.1080/02841850312331287829.
To evaluate the outcome of our patients with central retinal artery occlusion after local fibrinolysis and to compare these data with results reported in the literature.
Over a period of 7 years, 22 patients (11 male, 11 female, mean age 64.6 +/- 12.1 years) were treated with super-selective local fibrinolysis. In 1 case, treatment was carried out via the maxillary-ophthalmic anastomoses due to preexisting occlusion of the ipsilateral internal carotid artery. The latency period from the onset of symptoms to the beginning of therapy was 7.6 +/- 1.8 h. Urokinase was used in 7 cases (300,000-1.1 million units) and recombinant tissue plasminogen activator (20-40 mg) was applied in 15 patients. Visual acuity and fundus were examined before and after treatment.
One patient (1/22 = 4.6%) recovered completely and regained a visual acuity of 20/20. Six patients (6/22 = 27.3%) showed a marked improvement with a range of visual outcome from 20/800 to 20/320. In 2 cases (2/22 = 9.1%) only a slight improvement was observed, with a visual outcome allowing detection of hand movements. In 13 cases (13/22 = 59.1%) no change in visual acuity as a result of treatment was observed. In 2/22 cases (9.2%) reversible neurological side-effects occurred, in 1 case suffered a stroke, and in another case intracerebral bleeding was observed.
In our study, the recovery of visual acuity and the complication rate were not as positive as reported in the literature.
评估局部纤溶治疗后视网膜中央动脉阻塞患者的预后，并将这些数据与文献报道的结果进行比较。
在7年的时间里，对22例患者（男11例，女11例，平均年龄64.6±12.1岁）进行了超选择性局部纤溶治疗。1例患者因同侧颈内动脉预先存在阻塞，通过上颌-眼动脉吻合进行治疗。从症状出现到开始治疗的潜伏期为7.6±1.8小时。7例患者使用了尿激酶（300,000 - 1,100,000单位），15例患者应用了重组组织型纤溶酶原激活剂（20 - 40毫克）。治疗前后检查了视力和眼底。
1例患者（1/22 = 4.6%）完全康复，视力恢复到20/20。6例患者（6/22 = 27.3%）有明显改善，视力范围从20/800到20/320。2例患者（2/22 = 9.1%）仅略有改善，视力结果仅能检测到手的动作。13例患者（13/22 = 59.1%）治疗后视力无变化。2/22例患者（9.2%）出现可逆性神经副作用，1例发生中风，另1例观察到脑出血。
在我们的研究中，视力恢复情况和并发症发生率不如文献报道的那样乐观。
