Baumgartner, Philipp; Kook, Lucas; Altersberger, Valerian L; Gensicke, Henrik; Ardila-Jurado, Elena; Kägi, Georg; Salerno, Alexander; Michel, Patrik; Gopisingh, Kiran M; Nederkoorn, Paul J; Scheitz, Jan F; Nolte, Christian H; Heldner, Mirjam R; Arnold, Marcel; Cordonnier, Charlotte; Della Schiava, Lucie; Hametner, Christian; Ringleb, Peter A; Leker, Ronen R; Jubran, Hamza; ... (2023). Safety and effectiveness of IV Thrombolysis in retinal artery occlusion: A multicenter retrospective cohort study. European stroke journal, 8(4), pp. 966-973. Sage 10.1177/23969873231185895
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BACKGROUND
Retinal artery occlusion (RAO) may lead to irreversible blindness. For acute RAO, intravenous thrombolysis (IVT) can be considered as treatment. However, due to the rarity of RAO, data about IVT safety and effectiveness is limited.
METHODS
From the multicenter database ThRombolysis for Ischemic Stroke Patients (TRISP), we retrospectively analyzed visual acuity (VA) at baseline and within 3 months in IVT and non-IVT treated RAO patients. Primary outcome was difference of VA between baseline and follow up (∆VA). Secondary outcomes were rates of visual recovery (defined as improvement of VA ⩾ 0.3 logMAR), and safety (symptomatic intracranial hemorrhage (sICH) according to ECASS II criteria, asymptomatic intracranial hemorrhage (ICH) and major extracranial bleeding). Statistical analysis was performed using parametric tests and a linear regression model adjusted for age, sex and baseline VA.
RESULTS
We screened 200 patients with acute RAO and included 47 IVT and 34 non-IVT patients with complete information about recovery of vision. Visual Acuity at follow up significantly improved compared to baseline in IVT patients (∆VA 0.5 ± 0.8, p < 0.001) and non-IVT patients (∆VA 0.40 ± 1.1, p < 0.05). No significant differences in ∆VA and visual recovery rate were found between groups at follow up. Two asymptomatic ICH (4%) and one (2%) major extracranial bleeding (intraocular bleeding) occurred in the IVT group, while no bleeding events were reported in the non-IVT group.
CONCLUSION
Our study provides real-life data from the largest cohort of IVT treated RAO patients published so far. While there is no evidence for superiority of IVT compared to conservative treatment, bleeding rates were low. A randomized controlled trial and standardized outcome assessments in RAO patients are justified to assess the net benefit of IVT in RAO.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology |
UniBE Contributor: |
Kägi, Georg Heinrich, Heldner, Mirjam Rachel, Arnold, Marcel |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2396-9881 |
Publisher: |
Sage |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
10 Jul 2023 12:12 |
Last Modified: |
25 Nov 2023 00:12 |
Publisher DOI: |
10.1177/23969873231185895 |
PubMed ID: |
37421135 |
Uncontrolled Keywords: |
IVT Retinal artery occlusion central retinal artery thrombolysis visual acuity |
BORIS DOI: |
10.48350/184605 |
URI: |
https://boris.unibe.ch/id/eprint/184605 |
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