Steinkamp G W, Hattenbach L O, Scharrer I, Ohrloff C
Zentrum Augenheilkunde, Universitäts-Klinikum Frankfurt/Main.
Ophthalmologe. 1994 Jun;91(3):280-2.
Although central retinal vein occlusion and branch retinal vein occlusion are among the most common vascular disorders affecting the retina, there is a great deal of confusion about their management. In view of the histopathological features of ischemic retinal vein occlusions, the use of fibrinolytic agents such as rt-PA (recombinant tissue-plasminogen activator) appears to be the most promising therapeutic approach.
In nine patients with ischemic retinal vein occlusion, 50 mg of rt-PA were given i.v. over a period of 60 min. Simultaneously, heparin was infused at 1200 U/h. The i.v. heparinization was continued over a period of 8 days.
The clinical course was assessed by documenting visual acuity, fluorescein angiographies and fundal examinations. Additionally, several coagulation parameters were measured. No hemorrhagic complications were observed. In 8 cases, an improvement of visual acuity and retinal perfusion was noted.
Based on our results, we would recommend the fibrinolytic therapy with rt-PA and heparin in the treatment of ischemic retinal vein occlusions.
尽管视网膜中央静脉阻塞和视网膜分支静脉阻塞是影响视网膜的最常见血管疾病，但对其治疗仍存在很多困惑。鉴于缺血性视网膜静脉阻塞的组织病理学特征，使用纤溶药物如rt-PA（重组组织型纤溶酶原激活剂）似乎是最有前景的治疗方法。
9例缺血性视网膜静脉阻塞患者，静脉注射50mg rt-PA，持续60分钟。同时，以1200U/h的速度静脉输注肝素。静脉肝素化持续8天。
通过记录视力、荧光素血管造影和眼底检查来评估临床过程。此外，还测量了几个凝血参数。未观察到出血并发症。8例患者视力和视网膜灌注有所改善。
基于我们的结果，我们建议在缺血性视网膜静脉阻塞的治疗中采用rt-PA和肝素进行纤溶治疗。
