Selective thrombolysis of central retinal artery occlusion without long- term systemic heparinization

William J. Wirostko, Jose S. Pulido, Lloyd E. Hendrix

Research output: Contribution to journalArticlepeer-review

15 Scopus citations

Abstract

BACKGROUND: A central retinal artery occlusion is a potentially blinding retinal vascular event with no effective treatment regimen available. Recently, a few reports have described improved vision in eyes with central retinal artery occlusions after selective fibrinolytic therapy followed by long-term systemic anticoagulation. Acceptance of this treatment, however, has been hampered by a paucity of confirmatory reports and its potential for producing serious hemorrhagic complications. Our report independently confirms the beneficial effects of selective thrombolysis, even with the use of only short-term, post-procedure systemic heparinization. METHODS: A case report of selective fibrinolysis of an occluded central retinal artery using urokinase infusion into the ophthalmic artery followed with only 12 h of systemic heparinization is described. RESULTS: A 65-year-old man presenting with a central retinal artery occlusion of less than 4-h duration enjoyed an improvement of vision from counting-fingers acuity to 20/20 after selective fibrinolysis with urokinase and only 12 h of systemic heparinization. No hemorrhagic or thrombotic complications occurred. CONCLUSIONS: Selective thrombolysis with urokinase followed by short-term systemic heparinization can effectively treat a central retinal artery occlusion. Whereas the authors acknowledge that a single case does not prove that short-term heparinization is better than long-term heparinization, it does show that the latter is not always required.

Original languageEnglish (US)
Pages (from-to)408-410
Number of pages3
JournalSurgical Neurology
Volume50
Issue number5
DOIs
StatePublished - Nov 1 1998

Keywords

  • Central retinal artery occlusion
  • Selective fibrinolysis
  • Urokinase

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

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