Observation on therapeutic efficacy of rt-PA intravenous thrombolysis combined with compound anisodine injection on central retinal artery occlusion

Abstract

The aim of the present study was to observe the clinical efficacy and safety of recombinant tissue plasminogen activator (rt-PA) combined with compound anisodine in treating central retinal artery occlusion (CRAO). Forty-eight patients diagnosed with CRAO were randomly divided into a treatment group (24 cases) and a control group (24 cases). For the control group, nitroglycerin, 654-2, methazolamide, puerarin and compound anisodine were used for the treatment, along with oxygen, massage and other conventional treatments. Besides conventional therapy, the treatment group was also given intravenous rt-PA thrombolysis. Visual acuity, fundus oculi, visual field changes were taken as indicators for efficacy evaluation. It was found that the total effective rate of the control group was 70.83%, while that for the treatment group was 91.67%, and the comparative difference between the two groups was of statistical significance (p<0.05). The visual field defect of the control group after treatment was approximately 74.26±12.91%, and the visual field defect of the treatment group after treatment approximately 35.08±16.33%; thus, the comparative difference was statistically significant (p<0.01). The comparative difference of the original contents of fibrous protein in blood in the treatment group before and after treatment was statistically significant (p<0.01). In conclusion, the result show that intravenous thrombolysis with rt-PA combined with compound anisodine is safe and effective in treating CRAO, which can significantly improve the prognosis of patients.

Intravenous recombinant tissue-type plasminogen activator thrombolysis for acute central retinal artery occlusion: a meta-analysis

“…However, a more detailed large-scale RCT is warranted to strengthen evidence-based therapeutic guidance. [7] Germany, 2008 Chen et al [8] Australia, 2011 Nedelmann et al [9] Germany, 2015 Wu et al [10] China, 2016 Pre´terre et al [11] France, 2017 Schultheiss et al [12] Germany, 2018 No Changes in BCVA were defined as improvement (increase of 3 or more Snellen VA lines), stable (within <3 lines from baseline VA), and worse (loss of 3 or more Snellen VA lines). Improvement was defined in Snellen VA by ≥3 lines between baseline and 6 months, equating to a >0.3 change in the logMAR vision score.…”

“…As a thrombolytic agent, rt-PA can be administered intravenously or intra-arterially for the treatment of CRAO [10,1618]. Intravenous administration has the advantage of easier access with the nonspecialized physicians in the emergency room and reduced risk of haemorrhagic complications [1719].…”

“…The major reasons for this negative finding of the study included the small sample size (8 patients in the treatment group) and prolonged therapeutic time window from symptom onset to treatment with the average time of 14.4h. Yet another RCT concluded that 16 of 24 patients (66.7%) had exhibited significant visual improvement [10]. In general, the improvement rate of VA following intravenous rt-PA treatment ranged from 0% to 83.3% [6][7][8][9][10][11][12].…”

“…After exclusion of duplicate studies, a total of 118 articles were initially identified; however, 111 were rejected based on the exclusion criteria. A total of seven remaining full-text articles that met inclusion criteria were included in this meta-analysis [6][7][8][9][10][11][12]. Two of these studies were randomized trial [8,10], three were prospective study [7,9,12], one was a pilot study [6], and one was a retrospective study [11].…”

“…Patients received the low-dosedose of 50mg rt-PA in only one study [7] and the conventional dose of 0.9mg/kg (maximum, 90 mg) in the other six studies [6,[8][9][10][11][12]. There was heterogeneity in the time from the onset of symptoms to treatment in all studies.…”