Treatment of central retinal vein occlusion by injection of tissue plasminogen activator into a retinal vein

doi:10.1016/S0002-9394(98)00086-5

American Journal of Ophthalmology

Volume 126, Issue 1, July 1998, Pages 142-144

https://doi.org/10.1016/S0002-9394(98)00086-5 Get rights and content

Abstract

Purpose: To report the injection of tissue plasminogen activator into a retinal vein to treat central retinal vein occlusion.

Methods: An 81-year-old woman with visual loss of the right eye secondary to central retinal vein occlusion developed central retinal vein occlusion and visual loss in her left eye. Treatment of her left eye with topical ocular hypotensive medications, pentoxifylline, and laser chorioretinal anastomosis was without benefit. Thereafter, she underwent vitreoretinal surgery, including tissue plasminogen activator injection into a branch retinal vein of her left eye.

Results: The patient reported subjective improvement in the vision of her left eye. Ophthalmoscopic and fluorescein angiographic improvement were also noted.

Conclusion: The feasibility of cannulating a retinal vein for treatment has been demonstrated.

References (5)

A.K. Vine et al.
The role of abnormalities in the anticoagulant and fibrinolytic systems in retinal vascular occlusions
Surv Ophthalmol
(1993)
Risk factors for central retinal vein occlusion
Arch Ophthalmol
(1996)

There are more references available in the full text version of this article.

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Citation Excerpt :
Blood enters the eye through the central retinal artery (CRA) and leaves through the central retinal vein (CRV). Due to high blood pressure or glaucoma, there is a risk of clotting of blood in the CRV which leads to retinal injury or Central Retinal Vein Occlusion (CRVO) [8]. Most of the signals in practice are time-domain raw signals.
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Brief ReportsTreatment of central retinal vein occlusion by injection of tissue plasminogen activator into a retinal vein

Abstract

Surv Ophthalmol

Risk factors for central retinal vein occlusion

Arch Ophthalmol

Brief Reports
Treatment of central retinal vein occlusion by injection of tissue plasminogen activator into a retinal vein