Superselective Ophthalmic Arterial Fibrinolysis with Urokinase for Recent Severe Central Retinal Venous Occlusion: Initial Experience

Vallée, Jean-Noël; Massin, Pascale; Aymard, A; Pâques, M.; Herbreteau, Denis; Santiago, P. Y.; Losser, Marie-Reine; Gaudric, Alain; Merland, J. J.

doi:10.1148/radiology.216.1.r00jl2047

Cited by 7 publications

(9 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[2][3][4] This is the first reported local fibrinolysis using a direct ophthalmic artery puncture. The direct superselective approach reduces the systemic risks of fibrinolysis in a nonlife-threatening condition such as retinal vascular occlusion.…”

Section: Discussionmentioning

confidence: 91%

See 1 more Smart Citation

Optic Canal Decompression and Direct Ophthalmic Artery Fibrinolysis for Traumatic Optic Neuropathy With Central Retinal Artery Occlusion

Vaitheeswaran

Kaur

Garg

et al. 2014

Neuro-Ophthalmology

View full text Add to dashboard Cite

Central retinal artery occlusion is a rare association of traumatic optic neuropathy. Superselective fibrinolytic therapy is a management option for central artery occlusion that reduces systemic side effects of thrombolysis. A rare case of posttraumatic central retinal artery occlusion is described where optic nerve decompression was performed followed by restoration of central retinal flow by direct puncture of ophthalmic artery and institution of fibrinolytic therapy.

show abstract

Section: Discussionmentioning

confidence: 91%

“…1,2 The use of superselective ophthalmic artery fibrinolysis has recently been described in cases of retinal vascular occlusion. [3][4][5] However, this may not be effective in the setting of an associated compressive optic neuropathy due to trauma.…”

mentioning

confidence: 99%

Optic Canal Decompression and Direct Ophthalmic Artery Fibrinolysis for Traumatic Optic Neuropathy With Central Retinal Artery Occlusion

Vaitheeswaran

Kaur

Garg

et al. 2014

Neuro-Ophthalmology

View full text Add to dashboard Cite

show abstract

“…VallØe et al [81] berichteten über eine Katheterisierung der Arteria ophthalmica via Arteria femoralis mit Perfusion von Urokinase über 40 Minuten. 5 von 13 behandelten Patienten zeigten eine Visusverbesserung und Perfusion der verschlossenen Vene innerhalb von 24 -48 Stunden.…”

Section: Therapieunclassified

Chirurgische Therapie retinaler Venenverschlüsse

Mester

2005

Klin Monatsbl Augenheilkd

View full text Add to dashboard Cite

Retinal vein occlusions are the second most common vision threatening retinal vascular disorders. Our therapeutic armamentarium for functional improvement was very limited in the past for all types of retinal vein occlusions (branch, central and hemi-central retinal vein occlusion). Also pathomechanism and risk factors are not completely understood yet. Argon-laser-photocoagulation can prevent the development and treat neovascularizations successfully, but is unable to improve visual function in most cases. Thrombolytic therapy applied systemically is limited due to serious side effects but may be helpful when injected intraocularly. Isovolemic hemodilution may be efficacious in central retinal vein occlusion (CRVO). The creation of a laser-induced chorioretinal venous anastomosis showed serious complications. Since 1999 numerous reports on successful surgical techniques were published. It could be shown that the dissection of the adventitial sheath with separation of the artery from the vein at the arteriovenous crossing where branch retinal vein occlusion occurs can re-establish the retinal blood flow with reduction of macular edema. But it is still unclear which step of the surgery (vitrectomy, ILM-peeling, sheathotomy) is causative for the results. A new surgical approach in CRVO is the radial optic neurotomy (RON). This technique was primarily performed under the hypothesis of decompression of the central vein by cutting the scleral ring. Meanwhile there is some evidence that the formation of chorioretinal shunts may be the decisive factor in cases of successfully performed RON. Due to inconsistent and rare data this surgical procedure needs further evaluation. Another surgical option is the cannulation of the occluded vein. This technique seems to be feasible but the clinical results still have to be proved. Despite several uncertainties and open questions, surgical techniques are likely to overcome the desolate therapeutic situation for retinal vein occlusion of the past.

show abstract

“…In this way, this technique aims to maximise the concentration of fibrinolytic agent close to obstruction site and reduce the side effects of systemic fibrinolysis complications. There are some studies which use this technique in the patients with CRVO [25][26][27] . In these studies, the technique was performed by interventional neuroradiologists in the angiography room with the patient under neuroleptanalgesia.…”

Section: Introductionmentioning

confidence: 99%

“…Paques et al [25] reported that selective ophthalmic artery infusion of urokinase was followed by improvement in visual acuity in 6 out of 26 cases of CRVO and eyes with combined central retinal arterial occlusion (CRAO) and CRVO with recent visual loss appeared to be the most responsive. In addition, Vallée et al [26] performed this technique to 13 patients who had recent severe non-ischemic CRVO for which no alternative therapy was available. 5 of the 13 patients treated experienced visual improvement and retinal perfusion within 24-48 hours.…”

Section: Introductionmentioning

confidence: 99%

Fibrinolytic and Surgical Treatment Approaches for Retinal Vein Occlusion

Tekin¹,

Teke²,

İnanç³

2016

International Journal of Ophthalmic Research

View full text Add to dashboard Cite

Retinal vein occlusion (RVO) is the second most common vascular disease after diabetic retinopathy. Although its high frequency, mechanisms underlying RVO and optimal treatment strategies are still controversial. There are various treatment modalities for retinal vein occlusion including observation, systemic treatments, intravitreal agents, laser photocoagulation, fibrinolytic treatment and surgical approaches. Despite most of the treatment strategies are directed at secondary complications of RVO that affect vision including macular edema and retinal neovascularization, some treatment options also have the ability to create a bypass around the obstructed retinal vein and to decrease the raised venous hydrostatic pressure. The aim of this review is to describe the outcomes of fibrinolytic and surgical treatment modalities for RVO.

show abstract

Superselective Ophthalmic Arterial Fibrinolysis with Urokinase for Recent Severe Central Retinal Venous Occlusion: Initial Experience

Abstract: Although there was no control group, the short period between fibrinolysis and substantial visual improvement, combined with marked retinal perfusion improvement, suggests that fibrinolysis is beneficial for CRVO, especially for recent CRAO and CRVO.

Cited by 7 publications

References 30 publications

Optic Canal Decompression and Direct Ophthalmic Artery Fibrinolysis for Traumatic Optic Neuropathy With Central Retinal Artery Occlusion

Optic Canal Decompression and Direct Ophthalmic Artery Fibrinolysis for Traumatic Optic Neuropathy With Central Retinal Artery Occlusion

Chirurgische Therapie retinaler Venenverschlüsse

Fibrinolytic and Surgical Treatment Approaches for Retinal Vein Occlusion

Contact Info

Product

Resources

About