PDF(Pubmed)
Abstract：
UNASSIGNED: Retinal artery occlusion (RAO) may lead to irreversible blindness. For acute RAO, intravenous thrombolysis (IVT) can be considered as treatment. However, due to the rarity of RAO, data about IVT safety and effectiveness is limited.
UNASSIGNED: From the multicenter database ThRombolysis for Ischemic Stroke Patients (TRISP), we retrospectively analyzed visual acuity (VA) at baseline and within 3 months in IVT and non-IVT treated RAO patients. Primary outcome was difference of VA between baseline and follow up (∆VA). Secondary outcomes were rates of visual recovery (defined as improvement of VA ⩾ 0.3 logMAR), and safety (symptomatic intracranial hemorrhage (sICH) according to ECASS II criteria, asymptomatic intracranial hemorrhage (ICH) and major extracranial bleeding). Statistical analysis was performed using parametric tests and a linear regression model adjusted for age, sex and baseline VA.
UNASSIGNED: We screened 200 patients with acute RAO and included 47 IVT and 34 non-IVT patients with complete information about recovery of vision. Visual Acuity at follow up significantly improved compared to baseline in IVT patients (∆VA 0.5 ± 0.8, p < 0.001) and non-IVT patients (∆VA 0.40 ± 1.1, p < 0.05). No significant differences in ∆VA and visual recovery rate were found between groups at follow up. Two asymptomatic ICH (4%) and one (2%) major extracranial bleeding (intraocular bleeding) occurred in the IVT group, while no bleeding events were reported in the non-IVT group.
UNASSIGNED: Our study provides real-life data from the largest cohort of IVT treated RAO patients published so far. While there is no evidence for superiority of IVT compared to conservative treatment, bleeding rates were low. A randomized controlled trial and standardized outcome assessments in RAO patients are justified to assess the net benefit of IVT in RAO.
UNASSIGNED: From the multicenter database ThRombolysis for Ischemic Stroke Patients (TRISP), we retrospectively analyzed visual acuity (VA) at baseline and within 3 months in IVT and non-IVT treated RAO patients. Primary outcome was difference of VA between baseline and follow up (∆VA). Secondary outcomes were rates of visual recovery (defined as improvement of VA ⩾ 0.3 logMAR), and safety (symptomatic intracranial hemorrhage (sICH) according to ECASS II criteria, asymptomatic intracranial hemorrhage (ICH) and major extracranial bleeding). Statistical analysis was performed using parametric tests and a linear regression model adjusted for age, sex and baseline VA.
UNASSIGNED: We screened 200 patients with acute RAO and included 47 IVT and 34 non-IVT patients with complete information about recovery of vision. Visual Acuity at follow up significantly improved compared to baseline in IVT patients (∆VA 0.5 ± 0.8, p < 0.001) and non-IVT patients (∆VA 0.40 ± 1.1, p < 0.05). No significant differences in ∆VA and visual recovery rate were found between groups at follow up. Two asymptomatic ICH (4%) and one (2%) major extracranial bleeding (intraocular bleeding) occurred in the IVT group, while no bleeding events were reported in the non-IVT group.
UNASSIGNED: Our study provides real-life data from the largest cohort of IVT treated RAO patients published so far. While there is no evidence for superiority of IVT compared to conservative treatment, bleeding rates were low. A randomized controlled trial and standardized outcome assessments in RAO patients are justified to assess the net benefit of IVT in RAO.
摘要：
■视网膜动脉闭塞(RAO)可能导致不可逆的失明。对于急性RAO，静脉溶栓（IVT）可视为治疗。然而,由于RAO的稀有性,关于IVT安全性和有效性的数据有限。
■来自多中心数据库的缺血性卒中患者（TRISP），我们回顾性分析了IVT和非IVT治疗的RAO患者在基线和3个月内的视力(VA).主要结果是基线和随访之间的VA差异（ΔVA）。次要结果是视力恢复率（定义为VA0.3logMAR的改善），和安全性（症状性颅内出血（sICH）根据ECASSII标准，无症状颅内出血（ICH）和主要颅外出血）。使用参数检验和调整年龄的线性回归模型进行统计分析，性别和基线VA。
■我们筛选了200例急性RAO患者，包括47例IVT和34例非IVT患者，这些患者具有关于视力恢复的完整信息。与基线相比，IVT患者的随访视力显着改善（ΔVA0.5±0.8，p<0.001）和非IVT患者（ΔVA0.40±1.1，p<0.05）。随访时，各组之间的ΔVA和视力恢复率没有显着差异。IVT组发生2例无症状ICH(4%)和1例(2%)严重颅外出血(眼内出血),而非IVT组未报告出血事件。
■我们的研究提供了迄今为止发表的最大的IVT治疗RAO患者队列的真实数据。虽然没有证据表明IVT与保守治疗相比具有优越性，出血率低。在RAO患者中进行随机对照试验和标准化结果评估是合理的，以评估RAO中IVT的净益处。
■来自多中心数据库的缺血性卒中患者（TRISP），我们回顾性分析了IVT和非IVT治疗的RAO患者在基线和3个月内的视力(VA).主要结果是基线和随访之间的VA差异（ΔVA）。次要结果是视力恢复率（定义为VA
■我们筛选了200例急性RAO患者，包括47例IVT和34例非IVT患者，这些患者具有关于视力恢复的完整信息。与基线相比，IVT患者的随访视力显着改善（ΔVA0.5±0.8，p<0.001）和非IVT患者（ΔVA0.40±1.1，p<0.05）。随访时，各组之间的ΔVA和视力恢复率没有显着差异。IVT组发生2例无症状ICH(4%)和1例(2%)严重颅外出血(眼内出血),而非IVT组未报告出血事件。
■我们的研究提供了迄今为止发表的最大的IVT治疗RAO患者队列的真实数据。虽然没有证据表明IVT与保守治疗相比具有优越性，出血率低。在RAO患者中进行随机对照试验和标准化结果评估是合理的，以评估RAO中IVT的净益处。
