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Systemic thrombolysis for acute central retinal artery occlusion in sickle cell disease: Case report
We describe a 42-year-old African- American man with SCD (HbSS) who presented with an acute central retinal artery occlusion (CRAO) within an hour of onset and subsequently received IV thrombolysis with alteplase. His labs were significant for HbS 91%. He had no central vascular access to undergo emergent red blood cell (RBC) exchange so interventional radiology was consulted to minimize his bleeding risk after receiving tissue plasminogen activator (tPA). A right internal jugular catheter was placed with fluoro-guidance, resulting in minimal blood loss. After two sessions of RBC exchange, his HbS decreased to 26%. He repo...
Source: Journal of the National Medical Association - September 26, 2022 Category: General Medicine Authors: Estevana Isaac Ali A Saherwal Shaista Alam Source Type: research

Update on intravenous lysis treatment : The REVISION trial
CONCLUSION: The efficacy of intravenous thrombolysis in acute ischemic stroke is critically time dependent. This may also be assumed in acute CRAO; however, definite evidence still needs to be provided. Until then, the motto "time is retina" should be applied and intravenous thrombolysis should be offered to CRAO patients as part of randomized trials (such as REVISION). According to the current literature, other acute treatment approaches (such as paracentesis) are not indicated.PMID:34351478 | DOI:10.1007/s00347-021-01467-5
Source: Der Ophthalmologe - August 5, 2021 Category: Opthalmology Authors: Maximilian Schultheiss Martin S Spitzer Lars-Olof Hattenbach Sven Poli Source Type: research

Thrombolysis for Central Retinal Artery Occlusion in 2020: Time Is Vision!
Conclusions: In 2020, nonarteritic CRAO patients should theoretically receive the same thrombolytic therapies, in the same time window, as patients with acute cerebral ischemia. Eye stroke and teleeye stroke code encounters must include an expert ophthalmologic evaluation to confirm the correct diagnosis and to evaluate for ocular signs that may help guide IV tPA administration or IA management. Future research should focus on developing feasible retinal penumbra imaging studies that, similar to cerebral tissue viability or perfusion imaging, can be incorporated into the thrombolysis decision-making algorithm.
Source: Journal of Neuro-Ophthalmology - August 25, 2020 Category: Opthalmology Tags: Disease of the Year: Cerebrovascular Disorders Source Type: research