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Early Onset of Neovascular Glaucoma After Intra-Arterial Thrombolysis for Central Retinal Artery Occlusion: A

Olga Furashova1, Joerg Thalwitzer2, Egbert Matthé3

  • 1Department of Ophthalmology, Klinikum Chemnitz gGmbH, Chemnitz, Germany.

Clinical Ophthalmology (Auckland, N.Z.)
|May 2, 2022
PubMed

Insights

Intra-arterial thrombolysis for central retinal artery occlusion (CRAO) may be associated with early neovascular glaucoma. Four of six patients developed this complication weeks after treatment for CRAO.

Area of Science:

  • Ophthalmology
  • Vascular Medicine
  • Neurology

Background:

  • Central retinal artery occlusion (CRAO) is a critical condition leading to vision loss.
  • Neovascular glaucoma (NVG) is a severe complication often associated with retinal vascular diseases.
  • Intra-arterial thrombolysis is a treatment option for acute CRAO.

Purpose of the Study:

  • To report on the occurrence of early-onset neovascular glaucoma in patients treated with intra-arterial thrombolysis for CRAO.
  • To investigate the potential association between CRAO treatment and subsequent NVG development.

Main Methods:

  • Retrospective analysis of medical records of six consecutive patients with acute CRAO.
  • All patients received intra-arterial thrombolysis within 4.5-6 hours of symptom onset.
  • Patients were monitored for complications, specifically neovascular glaucoma.

Main Results:

  • Six patients with acute CRAO were treated with intra-arterial thrombolysis.
  • None of the patients experienced visual improvement post-treatment.
  • Four out of six patients developed severe, painful neovascular glaucoma 4-7 weeks after CRAO onset.
  • Patients had no significant carotid stenosis or prior ophthalmic issues.

Conclusions:

  • Early-onset neovascular glaucoma can occur following intra-arterial thrombolysis for CRAO.
  • While CRAO itself may predispose to NVG, a possible association with intra-arterial thrombolysis warrants discussion.
  • Further research is needed to elucidate the exact relationship and underlying mechanisms.
Abstract

Keywords:
intra-arterial thrombolysisneovascular glaucomaretinal artery occlusion

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