Ocular Neovascularization With Retinal Vascular Occlusion

Fibrinolytic therapy aimed at early restoration of blood flow appears to be a promising therapeutic approach in haemorrhagic retinopathy. The risk of bleeding complications, a major problem with fibrinolysis, can be reduced by the use of low-dose thrombolytic regimens. In our study, 14 patients with ischaemic central (CRVO) or branch (BRVO) retinal vein occlusion who presented with severe visual loss and recent onset of symptoms were treated with a low dose (50 mg) of recombinant tissue plasminogen activator (rt-PA) and intravenous heparin. In 10 of 14 patients (7 CRVO, 3 BRVO), an increase in visual acuity of one line or more on the logarithmic visual acuity chart was noted and in 8 patients (6 CRVO, 2 BRVO) a reduction of areas of capillary non-perfusion was observed, suggesting that a restoration of retinal capillary blood flow can be achieved if fibrinolysis is initiated in the early phase of haemorrhagic retinopathy. In view of the poor prognosis in the natural course of haemorrhagic retinopathy and the potential haemorrhagic risk in fibrinolysis, the use of low-dose rt-PA appears to constitute an encouraging approach in the management of this disease.

Section: Discussionsupporting

confidence: 42%

Section: Introductionsupporting

confidence: 42%

Section: Introductionsupporting

confidence: 39%

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Fibrinolytic Therapy with Low-Dose Recombinant Tissue Plasminogen Activator in Retinal Vein Occlusion

Hattenbach¹,

Steinkamp²,

Scharrer

et al. 1998

“…Tissue damage resulting from ischemia activates a cascade of events which represents an inflammatory response that occurs independently of any improvement in tissue reoxygenation [29]. Neutrophils can release various mediators capable of promoting tissue injury, including proteolytic enzymes, platelet-activating factor, arachidonic acid metabolites and activated species of oxygen.…”

Section: Discussionsupporting

confidence: 40%

Protective Effects of Pentoxifylline in Retinal Ischemia/Reperfusion Injury

Demır

Ulaş²,

Özercan³

et al. 2003

We studied the effect of pentoxifylline on retinal lipid peroxidation and histopathologic changes due to ischemia/reperfusion (I/R). A total of 15 pigmented male guinea pigs were divided into 3 equal groups as control, sham and treatment groups. After application of high intraocular pressure for 90 min for the induction of retinal ischemia, 24-hour reperfusion was established in the sham and treatment groups. In the treatment and sham groups, either 45 mg/kg of pentoxifylline or saline was given 3 times at 8-hour intervals. Biochemical assay and histopathologic evaluation were performed on one randomly selected eye of each animal which was enucleated at the end of the reperfusion period, and retinal malondialdehyde (MDA) levels and thickness of the retinal tissue were determined for each group. The mean MDA level of the sham group was significantly higher versus the control and treatment groups (p < 0.001). When compared with the control group, the mean MDA level of the treatment group was slightly higher, but the difference was not statistically significant (p > 0.05). In comparison with the control group there was a significant increase in the thickness of the retina in the sham group (p < 0.0001), and no significant difference was found in the retinal thickness of the treatment group (p > 0.05). Pentoxifylline might have a preventive effect on the I/R injury of the retina.

“…Similar effects of allopurinol and catalase have been shown previously [3, 30]. Studies confirm that I/R triggers sudden metabolic, electrophysiologic, morphologic and functional changes in the tissue [31, 32]. Free radicals can promote lipid peroxidation and degradation or cross-linking of protein or nucleic acid molecules.…”

Section: Discussionsupporting

confidence: 39%

<i>L</i>-Carnitine in Experimental Retinal Ischemia-Reperfusion Injury

Alagöz

Çeliker²,

İlhan³

et al. 2002

The effect of L-carnitine on retinal ischemia-reperfusion injury was evaluated in guinea pigs. 90 min of pressure-induced retinal ischemia followed by 24 h of reperfusion was established in both eyes of 2 groups of animals receiving either L-carnitine (100 mg/kg repeated in 5 doses) or saline intraperitoneally. After enucleation of all the eyes, including those of a control group, malonyldialdehyde (MDA) levels and the thickness of the retinal tissue were measured in 3 groups. The mean MDA value and the tissue thickness of the L-carnitine-treated group were statistically insignificant versus the control group (p > 0.05 and p > 0.05, respectively). However, these values were significantly different in the group receiving saline versus the control group and that receiving L-carnitine (p < 0.001, p < 0.001 and p < 0.001, p < 0.001 respectively). L-Carnitine might be an alternative drug for ischemia-reperfusion injury of the retina.