학술논문
Vision Salvage Using Intra-Ophthalmic Arterial Alteplase Combine with Nimodipine in Central Retinal Artery Occlusion (VISION)
Document Type
Clinical report
Author
Source
Clinical Ophthalmology. May 31, 2023, Vol. 17, p1215, 8 p.
Subject
Language
English
ISSN
1177-5483
Abstract
Purpose: To investigate the efficacy and safety of selective intra-ophthalmic arterial combined nimodipine and alteplase infusion in patients with central retinal artery occlusion (CRAO). Design: Non-randomized, prospective interventional study. Methods: All patients with CRAO who presented at our institute within 24 hours from CRAO onset from August 2020 to July 2022 were included. Intra-arterial nimodipine and alteplase were given selectively into the ophthalmic artery. Visual acuity was recorded during and after the procedure. Change in best corrected visual acuity (BCVA) 1 month post-treatment, relative to baseline, was set as the primary outcome measure. Significant improvement in vision and adverse events are reported as secondary outcomes. Patients: Nine patients with non-arteritic CRAO were enrolled. Results: A total of nine patients with CRAO underwent selective intra-ophthalmic arterial nimodipine and alteplase injection. Overall, BCVA had statistically significantly improved by 0.78 logarithm of the minimum angle of resolution (logMAR) at 1 month compared with baseline (95% confidence interval: (-1.24, -0.31), p-value = 0.001). Seven (77.8%) patients had significant visual improvement ([greater than or equal to] 0.3 logMAR) at 1-month post-treatment. There were minor adverse events during administration of the nimodipine, including chemosis and headache, which resolved after the discontinuation of nimodipine. There were also asymptomatic thromboembolic events in 2 patients (22.2%) after the intervention procedure, without any morbidity or mortality. Conclusion: The use of selective intra-ophthalmic arterial combined nimodipine and alteplase was efficacious in improving BCVA at 1 month for patients with non-arteritic CRAO presenting between 24 hours from onset, with minor adverse events but no serious adverse events. Keywords: central retinal artery occlusion, thrombolysis, intra-ophthalmic arterial thrombolysis
Introduction Central retinal artery occlusion (CRAO) is a rare condition with incidence of 1.8-2.5 per 100,000 person-years (1-3) which can result in permanent visual loss, less than 20% of affected [...]
Introduction Central retinal artery occlusion (CRAO) is a rare condition with incidence of 1.8-2.5 per 100,000 person-years (1-3) which can result in permanent visual loss, less than 20% of affected [...]