INTRAVENOUS THROMBOLYTIC THERAPY FOR ACUTE NONARTERITIC CENTRAL RETINAL ARTERY OCCLUSION. A REVIEW

Area of Science:

• Ophthalmology
• Neurology
• Vascular Medicine

Background:

• Central retinal artery occlusion (CRAO) is an acute ischemic stroke causing severe vision loss.
• Current conservative therapies for CRAO lack proven efficacy.
• CRAO can indicate a higher risk of cerebrovascular events.

Purpose of the Study:

• To review clinical studies on intravenous thrombolysis for CRAO.
• To evaluate the efficacy and safety of this treatment.
• To propose an optimal diagnostic and therapeutic algorithm for acute CRAO management.

Main Methods:

• Systematic review and meta-analysis of published clinical studies.
• Analysis of patient data regarding visual acuity improvement and adverse events.
• Evaluation of treatment efficacy within a 4.5-hour time window.

Main Results:

• Significant visual acuity improvement observed in 45% of patients treated with alteplase within 4.5 hours.
• Adverse events were not significantly increased within this time window.
• Intravenous thrombolysis shows potential efficacy and safety for CRAO.

Conclusions:

• Intravenous thrombolysis is a promising treatment for CRAO, particularly when administered early.
• Further randomized controlled trials are necessary to confirm these findings.
• Specialized centers should manage CRAO patients, ensuring prompt transport and comprehensive care.