1. Management of acute central retinal artery occlusion: Intravenous thrombolysis is feasible and safe
- Author
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Cédric Urbanczyk, Matthias Lamy, Xavier Vandamme, Pierre Lebranchu, Benoit Guillon, Gaëlle Godeneche, Cécile Preterre, Valérie Wolff, Thomas Ronzière, Mathieu Sevin-Allouet, Christophe Breuilly, Service de Neurologie [Rennes] = Neurology [Rennes], CHU Pontchaillou [Rennes], Département de Neurologie, Hopitaux Universitaires de Strasbourg, Laboratoire des Sciences du Numérique de Nantes (LS2N), Université de Nantes - UFR des Sciences et des Techniques (UN UFR ST), Université de Nantes (UN)-Université de Nantes (UN)-École Centrale de Nantes (ECN)-Centre National de la Recherche Scientifique (CNRS)-IMT Atlantique Bretagne-Pays de la Loire (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), Image Perception Interaction (IPI), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT)-Université de Nantes - UFR des Sciences et des Techniques (UN UFR ST), Service de Neurologie [Rennes], Université de Rennes 1 (UR1), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes]
- Subjects
Male ,Visual acuity ,Retinal Artery Occlusion ,medicine.medical_treatment ,Retinal Artery ,Hand motion ,Hemorrhage ,Tissue plasminogen activator ,03 medical and health sciences ,0302 clinical medicine ,[INFO.INFO-TS]Computer Science [cs]/Signal and Image Processing ,medicine ,Humans ,Thrombolytic Therapy ,Adverse effect ,Stroke ,ComputingMilieux_MISCELLANEOUS ,Aged ,Retrospective Studies ,business.industry ,Disease Management ,Thrombolysis ,Middle Aged ,medicine.disease ,3. Good health ,Neurology ,Tissue Plasminogen Activator ,Anesthesia ,Acute Disease ,030221 ophthalmology & optometry ,Feasibility Studies ,Central retinal artery occlusion ,Administration, Intravenous ,Female ,France ,medicine.symptom ,business ,030217 neurology & neurosurgery ,medicine.drug - Abstract
Background Although acute central retinal artery occlusion is as a stroke in the carotid territory (retinal artery), its management remains controversial. The aim of this study was to assess the feasibility and safety of intravenous thrombolysis delivered within 6 h of central retinal artery occlusion in French stroke units. Methods We performed a retrospective analysis of patients treated with intravenous alteplase (recombinant tissue-plasminogen activator), based on stroke units thrombolysis registers from June 2005 to June 2015, and we selected those who had acute central retinal artery occlusion. The feasibility was assessed by the ratio of patients that had received intravenous alteplase within 6 h after central retinal artery occlusion onset among those who had been admitted to the same hospital for acute central retinal artery occlusion. All adverse events were documented. Results Thirty patients were included. Visual acuity before treatment was limited to “hand motion”, or worse, in 90% of the cases. The mean onset-to-needle time was 273 min. The individuals treated with intravenous alteplase for central retinal artery occlusion represented 10.2% of all of the patients hospitalized for central retinal artery occlusion in 2013 and 2014. We observed one occurrence of major bleeding, a symptomatic intracerebral hemorrhage. Conclusion When applied early on, intravenous thrombolysis appears to be feasible and safe, provided that contraindications are given due consideration. Whether intravenous thrombolysis is more effective than conservative therapy remains to be determined. In order to conduct a well-designed prospective randomized control trial, an organized network should be in place.
- Published
- 2017
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