[Intra-retinal vein cannulation without tissue-type plasminogen activator for hemi-central retinal artery occlusion]

A 19-year-old woman presented sudden visual loss in the left eye for 1 day. Ophthalmic examination showed superior hemi-retinal whitening with thickening of the inner retinal layer and shadowing of the outer retina layer and delayed perfusion of the superior hemi-retinal artery and cilioretinal artery. We performed surgery at 34 hours after the onset. After vitrectomy, a 48G micro-needle was connected to the 1-cc syringe of the viscous fluid control unit of the vitrectomy machine. The needle tip was inserted into the lumen of the superior peripapillary branch retinal vein. Then balanced salt solution was injected without tissue-type plasminogen activator, till it entered the vein and nearby artery. After surgery, the patient's visual acuity restored to 1.0 at 7 days and kept unchanged for 4 weeks. This is the first report on intra-retinal vein cannulation without tissue-type plasminogen activator for 34 hours of hemi-central retinal artery occlusion. It is worth trying for improving visual acuity despite certain morphologic damage. ( Chin J Ophthalmol, 2020, 56: 536-538).