Dataset Information

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

ABSTRACT:

Purpose

To report on four cases of central retinal artery occlusion (CRAO) treated with intra-arterial thrombolysis with early onset neovascular glaucoma in the further disease course.

Patients and methods

Retrospective analysis of the medical records of six consecutive patients treated with intra-arterial thrombolysis for CRAO of which four developed neovascular glaucoma.

Results

All six patients were diagnosed with acute CRAO and treated with intra-arterial thrombolysis 4.5-6 hours after symptom onset. The patients had no significant carotid artery stenosis and unremarkable ophthalmic history. No visual improvement could be achieved after treatment. Four to seven weeks after CRAO onset, four of these patients developed severe painful neovascular glaucoma.

Conclusion

Early onset of aggressive neovascular glaucoma following intra-arterial thrombolysis for CRAO might be a complication of CRAO itself, still possible association with intra-arterial thrombolysis in our patients should be discussed.

SUBMITTER: Furashova O

PROVIDER: S-EPMC9041599 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Publications

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

Furashova Olga O Thalwitzer Joerg J Matthé Egbert E

Clinical ophthalmology (Auckland, N.Z.) 20220422

<h4>Purpose</h4>To report on four cases of central retinal artery occlusion (CRAO) treated with intra-arterial thrombolysis with early onset neovascular glaucoma in the further disease course.<h4>Patients and methods</h4>Retrospective analysis of the medical records of six consecutive patients treated with intra-arterial thrombolysis for CRAO of which four developed neovascular glaucoma.<h4>Results</h4>All six patients were diagnosed with acute CRAO and treated with intra-arterial thrombolysis 4 ...[more]

PMID: 35493970

Similar Datasets

Project description:Background and purposeRecent data suggest that intra-arterial thrombolytics may be a safe rescue therapy for patients with acute ischemic stroke after unsuccessful mechanical thrombectomy; however, safety and efficacy remain unclear. Here, we evaluate the use of intra-arterial rtPA as a rescue therapy in the Systematic Evaluation of Patients Treated with Neurothrombectomy Devices for Acute Ischemic Stroke (STRATIS) registry.Materials and methodsSTRATIS was a prospective, multicenter, observational study of patients with acute ischemic stroke with large-vessel occlusions treated with the Solitaire stent retriever as the first-line therapy within 8 hours from symptom onset. Clinical and angiographic outcomes were compared in patients having rescue therapy treated with and without intra-arterial rtPA. Unsuccessful mechanical thrombectomy was defined as any use of rescue therapy.ResultsA total of 212/984 (21.5%) patients received rescue therapy, of which 83 (39.2%) and 129 (60.8%) were in the no intra-arterial rtPA and intra-arterial rtPA groups, respectively. Most occlusions were M1, with 43.4% in the no intra-arterial rtPA group and 55.0% in the intra-arterial rtPA group (P = .12). The median intra-arterial rtPA dose was 4 mg (interquartile range = 2-12 mg). A trend toward higher rates of substantial reperfusion (modified TICI ≥ 2b) (84.7% versus 73.0%, P = .08), good functional outcome (59.2% versus 46.6%, P = .10), and lower rates of mortality (13.3% versus 23.3%, P = .08) was seen in the intra-arterial rtPA cohort. Rates of symptomatic intracranial hemorrhage did not differ (0% versus 1.6%, P = .54).ConclusionsUse of intra-arterial rtPA as a rescue therapy after unsuccessful mechanical thrombectomy was not associated with an increased risk of symptomatic intracranial hemorrhage or mortality. Randomized clinical trials are needed to understand the safety and efficacy of intra-arterial thrombolysis as a rescue therapy after mechanical thrombectomy.

Dataset Information

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

Purpose

Patients and methods

Results

Conclusion

Publications

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

Similar Datasets

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