Department of Ophthalmology, Second Faculty of Medicine Charles University and Motol University Hospital in Prague, V Uvalu 84, 150 06, Prague, Czech Republic.
Department of Probability and Mathematical Statistics, Faculty of Mathematics and Physics, Charles University in Prague, Prague, Czech Republic.
Sci Rep. 2023 Nov 22;13(1):20505. doi: 10.1038/s41598-023-47987-9.
Central retinal artery occlusion (CRAO) is an ophthalmologic emergency that can lead to irreversible loss of vision. Intravenous thrombolysis (IVT) has been used experimentally for its treatment. Our study aimed to evaluate the effect of emergency IVT on CRAO and its impact on visual acuity outcomes. We conducted a retrospective observational study of patients with CRAO. A total of 46 patients with CRAO were analysed; 16 patients received IVT treatment (IVT group) while 30 did not (no-IVT group). Seven patients from the IVT group received IVT early, within 4.5 hours (h) after the onset of symptoms (early-IVT), and 9 patients received it beyond this timeframe (late-IVT). The median time-to-hospital was 8.5 h: 3 h for the IVT group and 24 h for the no-IVT group. The median time-to-treatment was 5 h. The median outcome of visual acuity was 0.05 in the early-IVT, 0.025 in the late-IVT, and 0.01 in the no-IVT group. Among patients who received IVT early, 86% exhibited significant visual improvement. This improvement was four-fold greater compared to all other groups (p = 0.040), including the late-IVT (p = 0.011) and no-IVT groups (p = 0.023). No complications of the treatment were reported. Our study confirms that the administration of IVT treatment for CRAO within the 4.5-h time window is both safe and effective.
视网膜中央动脉阻塞（CRAO）是一种眼科急症，可导致视力不可逆转的丧失。静脉溶栓（IVT）已被用于其治疗的实验。我们的研究旨在评估紧急 IVT 对 CRAO 的影响及其对视敏度结果的影响。我们对 CRAO 患者进行了回顾性观察研究。共分析了 46 例 CRAO 患者；16 例患者接受 IVT 治疗（IVT 组），30 例未接受 IVT 治疗（无-IVT 组）。IVT 组中有 7 例患者在症状发作后 4.5 小时内（早期-IVT）接受了 IVT，9 例患者接受了 IVT 治疗（晚期-IVT）。中位数到达医院时间为 8.5 小时：IVT 组为 3 小时，无-IVT 组为 24 小时。中位数治疗时间为 5 小时。早期-IVT 组的视力平均结果为 0.05，晚期-IVT 组为 0.025，无-IVT 组为 0.01。在早期接受 IVT 的患者中，86%的患者视力显著改善。与其他所有组（p=0.040），包括晚期-IVT（p=0.011）和无-IVT 组（p=0.023）相比，这种改善幅度大四倍。未报告治疗的并发症。我们的研究证实，在 4.5 小时的时间窗口内对 CRAO 进行 IVT 治疗既安全又有效。
