The Comparative Study Of Thrombolysis Infusion Via Super Selective Ophthalmic Artery And Carotid Artery Catheterization Treating Central Retinal Artery Occlusion

Objective Central retinal artery occlusion which is rapid-onset and predicted poor is one of the ophthalmic emergency. It can cause acute retinal ischemia and hypoxia, leading to severe visual impairment and even blindness.It is one of the disease that seriously endangers vision and whose disability is very high.Compared with intravenous administration,availability of drug concentration in the retina through intra-arterial infusion thrombolysis is 117 times of the latter.Intra-arterial infusion thrombolysis can achieve rapid and effective therapeutic effect. Firstly,we evaluate the thrombolytic treatment effect of central retinal artery occlusion by the super selective ophthalmic artery and internal carotid artery catheterization. Secondly, through a comparative study of its efficacy,we are trying to use economic,safe and convient internal carotid artery thrombolysis instead of complex,expensive super-selective ophthalmic artery thrombolysis. Materials and Methods 30 cases which have been diagnosed with acute central retinal artery occlusion by ophthalmoscope and fundus fluorescein angiography were analyzed,including gender,age,clinical symptoms,etiology,effectiveness and complications.We randomly divided them into two groups.One group is 17 cases,the other group is 13cases.When Catheter were inserted into carotid artery siphon or ophthalmic artery,600000-700000u or 200000-300000u urokinase were respectively infused to thrombolytic therapy.Visual testing and FFA checking were applicated before and after treatment so as to observe the changes in vision and the imaging time of central retinal artery.Through the method of case-control study,we would have been carried out statistical analysis of the results. Results Before and after thrombolytic therapy,artery imaging time in the internal carotid artery treated group were respectively 41.6±12.7 seconds(12-62s),13.9±4.4 seconds (6-20s)(p<0.05). Artery imaging time in the super-selective ophthalmic artery treated group were respectively 45.2±19.2seconds(20-64s),14±3.3seconds(10-21s) (p<0.05).The difference between the two were both statistically significant.In the internal carotid artery and super selective ophthalmic artery treated groups,the rate of visual melioration is respectively 76.4% and 84.6% (p=0.57318>0.05). The difference of artery imaging time in FFA examition were respectively 27.7±18.8 seconds(4-54s),31.2±18.3 seconds(8-51s)(P>0.05).There were no significant difference between the two. Complications including intracranical hemorrhage,paralysis of the lower limb and vitreous hemorrhage occurred in the 4 patients. Conclusions The treatment of acute central retinal artery occlusion by carotid artery and super selective ophthalmic artery thrombolysis can be obtained distinct effect. As long as selecting cases strictly and holding characters exactly,We can use economic,safe and effective internal carotid artery instead of expensive,complex super-selective ophthalmic artery thrombolysis.