Retrospective study of threshold time for the conventional treatment of branch retinal artery occlusion

Abstract

PurposeTo investigate the medical backgrounds of patients and the treatment periods from the onset of branch retinal artery occlusion to obtaining improved final visual acuity.MethodsThis was a retrospective case series study. A total of 68 consecutive patients (69 eyes) with branch retinal artery occlusion who visited Tokyo Medical University Hospital from 2007 to 2012 were included in this study. All patients underwent ophthalmic examinations and visual acuity tests. We reviewed their medical records for systemic conditions, as well as the periods from onset of symptoms to treatment. Participants were categorized into 2 groups: group A (n=36), which received any treatment within 24 hours from onset, and group B (n=33), which visited our hospital after 24 hours from onset. Best corrected visual acuity (BCVA) changes from the first to final visit and the relationships between systemic condition and visiting time to BCVA were assessed.ResultsAt the first visit, 59% of the patients had BCVA over 20/40; the ratio was increased to 74% at the final visit. BCVA improved more than 2 lines for 35% of the patients and was unchanged for 57% of those receiving conventional treatment. BCVA over 20/40 was significantly lower in hyperlipidemia patients. Hypertension, diabetes mellitus, and significant carotid stenosis were not correlated. The mean BCVA at baseline (0.91±1.03) significantly recovered to 0.35±0.91 after treatment in group A (P<0.001, Student’s t-test). The mean BCVA at baseline (0.30±0.64) was 0.25±0.61 at the final visit in group B (no significant change).ConclusionConventional treatment within 24 hours from onset was acceptable for branch retinal artery occlusion.

Multiple branch retinal artery occlusions following the new facial cosmetic filler (Poly-D, L-lactic Acid) injection a case report

“…Early treatment appears to be as important in BRAO cases as it is in CRAO cases to avoid retinal damage after artery obstruction and ischemia. One study suggests 24 h threshold time for the conventional treatment for BRAO [19]. The present case came to our ED after 5 h of symptom onset and initial visit to another hospital.…”

Optical Coherence Tomography Angiography in Branch Retinal Artery Occlusion

“… 10 , 11 There is no consensus regarding the timing and method of retinal artery treatment. 12 , 13 , 14 Our patient presented 72 hours after the onset of symptoms and considering his initial visual acuity, we administered pentoxifylline and dextran therapy with the aim of increasing retinal tissue oxygenation via vasodilatation and hemodilution. Anticoagulant and antiaggregant drugs were used because of the patient’s comorbid conditions.…”