Value of local ophthalmic artery thrombolysis in patients with severe central retinal vein occlusion.

Purpose. To assess the value of selective ophthalmic artery thrombolysis as a treatment for central retinal vein occlusion (CRVO) for which no alterna tive therapy is available. Materials and Methods. Patients included in this study presented with recen t severe non-ischemic CRVO. Urokinase (300.000 IU) was perfused for 40 minu tes into the ophthalmic artery. Visual acuity, fundoscopy and retinal arter iovenous transit time were assessed during one year of follow-up. Results. Five of the 13 patients treated experienced a marked improvement o f vision (p=0.05) and retinal perfusion within 24-48 hours, acid exhibited progressive lesion regression at fundoscopy within 2-4weeks. The clinical c ourse of the 5 patients prior to treatment resembled that of combined centr al retinal artery and vein obstruction (CRAO/CRVO), which typically has a p oor visual outcome. One patient relapsed 1 month after thrombolysis. No tec hnical complications were observed. Conclusion. Although there was no control group, the short period between f ibrinolysis and significant visual improvement combined with marked retinal perfusion improvement, suggests that local thrombolysis is beneficial for CRVO, especially recent CRAO/CRVO.