Intra-arterial Thrombolysis for Central Retinal Artery Occlusion after the Coil Embolization of Paraclinoid Aneurysm

Yoo, Minwook; Jin, Sung-Chul; Kim, Hae Yu; Choi, Byeong-Sam

doi:10.7461/jcen.2016.18.4.369

Cited by 5 publications

(4 citation statements)

References 6 publications

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“…Mid-orbital OA filled from ECA collaterals with choroidal blushingrTPA 10 mgCommon carotid artery infused near origin of ECA – details not givenCFJeon et al50, 2016Atrial septal defect closureLP<3ICA patent with no occlusion of OA. No choroidal blush in ethmoidal and lacrimal branches of ECAUrokinase 500,000 units over 75 minMicrocatheter (Excelsior SL-10, Stryker)Angiogram showed restoration of posterior ciliary and muscular arteries20/30 with a left VF defect at inferonasal quadrantYoo et al51, 2016Coil embolization of paraclinoid aneurysmNot reportedImmediateNo choroidal blushUrokinase 100,000 and 500 mcg of tirofibanMicrocatheter (Excelsior SL-10, Stryker) placed in proximal segment of OAImproved visualisation of choroidal blushCFPark et al52, 2019Stent-assisted coil embolization of OANot reportedNot reportedNo retinal choroidal blush via OA and retrograde flow from the ECAUrokinase 200,000 units into common carotid and 100,000 units into OA. Systemic heparinisation.…”

Section: Resultsmentioning

confidence: 98%

<p>Intra-Arterial Thrombolysis for Central Retinal Artery Occlusion</p>

Hakim¹,

Hakim²

2019

OPTH

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IntroductionCentral retinal artery occlusion is an ophthalmic emergency which typically causes acute, painless visual loss. Several conservative treatment options are practiced with little benefit. Thrombolysis as a therapeutic option has gathered interest as well as controversy. This paper aims at reviewing the relevant literature to assess the efficacy and safety of intra-arterial thrombolysis for acute central retinal artery occlusion.MethodsA review of the literature was conducted. Keywords included “intra-arterial thrombolysis” or “intra-arterial fibrinolysis” in combination with “central retinal artery occlusion” or “CRAO”. A Cochrane Database search was performed for randomised control trials, systematic reviews and meta-analyses using the same keywords.ResultsTwenty-eight studies were identified which included case reports, case series, case-control studies and 1 randomised control trial: the European Assessment Group for Lysis in the Eye Study. Improvement in vision was measured using different methods and at different time points. The findings of these studies generally favour an effect towards intra-arterial thrombolysis however there are many limitations. Additionally, the European Assessment Group for Lysis in the Eye Study showed lack of effect in intra-arterial thrombolysis vs conservative measures.ConclusionCurrent evidence is not sufficient to recommend intra-arterial thrombolysis due to the variability of visual improvement within retrospective studies, heterogeneity in treatment regimens between studies and adverse effects. Intra-arterial thrombolysis may have a role in patients presenting early, particularly if they have monocular vision, after discussion of the risks and benefits. Further high-quality trials assessing the clinical efficacy of intra-arterial thrombolysis may shed more light on this topic.

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Section: Resultsmentioning

confidence: 98%

<p>Intra-Arterial Thrombolysis for Central Retinal Artery Occlusion</p>

Hakim¹,

Hakim²

2019

OPTH

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“…Although the association between PAMM and endovascular coil embolization has not been previously reported, there have been several cases of retinal artery occlusion caused by thrombiform coil embolization. 8,9 Yoo et al 9 speculated that endothelial injury during treatments such as microcatheter or microwire insertion could cause thrombi, thereby leading to retinal artery occlusion. When these findings are taken together, we can conclude that the endovascular coil embolization procedure is likely to be a precursor cause of PAMM.…”

Section: Discussionmentioning

confidence: 99%

Paracentral Acute Middle Maculopathy After Endovascular Coil Embolization

Nakamura

Katagiri

Hayashi

et al. 2021

RETINAL Cases &Amp; Brief Reports

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Purpose: To describe two cases of paracentral acute middle maculopathy (PAMM) that occurred unilaterally after endovascular coil embolization.Methods: Medical records including ophthalmic examinations of two PAMM cases were retrospectively reviewed.Results: The first case was a 64-year-old woman with hyperlipidemia and chronic sinusitis. The second case was a 49-year-old man with hypertension, hyperlipidemia, tension headache, and vertigo. Both cases exhibited paracentral scotomas just after endovascular coil embolization. Ophthalmoscopy showed multiple faint white-yellow lesions in each affected eye. Optical coherence tomography showed hyper-reflective bands that were mainly observed in the inner nuclear layer and corresponded to the PAMM lesions. Optical coherence tomography angiography revealed variable degrees of abnormal vasculature from slight dilation, decreased visualization, to nonvisualization in the superficial capillary plexuses and similar capillary changes in deep capillary plexuses. Conclusion:We described two cases with PAMM that occurred after endovascular coil embolization, which was a new precursor cause of PAMM. Our results demonstrate that optical coherence tomography angiography is especially useful for not only diagnosis, but also for follow-up evaluations in patients with PAMM.

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“…Because these ischemic areas spared the right fovea, the patient did not present any complaint in his right eye. Cases of retinal artery occlusion after aneurysm embolization are rare and poorly described in the literature [4] , [5] , [6] .…”

Section: Discussionmentioning

confidence: 99%