[Intra-arterial fibrinolysis in central artery occlusion]

Abstract

Central retinal artery occlusion is known to have a poor natural outcome, and also conventional therapeutic procedures e.g. paracentesis, hemodilution or local massage show unfavorable results. As in intraarterial fibrinolytic therapy in cerebral vessels, we also applied this method to the territory of the ophthalmic artery in 6 patients with occlusion of the central retinal artery. The fibrinolysis was done with a microcatheter superselectively, placed in the proximal part of the ophthalmic artery. The amount of urokinase varied from 200,000 to 900,000 IU, diluted in saline solution. In 5 patients, fluorescein angiography was carried out before and after fibrinolytic therapy, confirming the significant improvement of retinal and choroidal perfusion seen on the arterial ophthalmic angiogram. All patients showed an improvement of visual function after therapy, two patients even had a complete recovery of visual acuity.