VIsion Salvage Using Intra-Ophthalmic Arterial Alteplase Combine with Nimodipine in Central Retinal Artery Occlusion (VISION)
7
Issued Date
2023-01-01
Resource Type
ISSN
11775467
eISSN
11775483
Scopus ID
2-s2.0-85159167122
Journal Title
Clinical Ophthalmology
Volume
17
Start Page
1215
End Page
1222
Rights Holder(s)
SCOPUS
Bibliographic Citation
Clinical Ophthalmology Vol.17 (2023) , 1215-1222
Suggested Citation
Kobkitsuksakul C., Namphol N., Sirilert B., Kritfuangfoo T., Chanthanaphak E., Apirakkan M., Somboonnithiphol K., Boonyakarnkul S., Lueangapapong P., Thongborisuth T., Sujirakul T. VIsion Salvage Using Intra-Ophthalmic Arterial Alteplase Combine with Nimodipine in Central Retinal Artery Occlusion (VISION). Clinical Ophthalmology Vol.17 (2023) , 1215-1222. 1222. doi:10.2147/OPTH.S407617 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/82778
Title
VIsion Salvage Using Intra-Ophthalmic Arterial Alteplase Combine with Nimodipine in Central Retinal Artery Occlusion (VISION)
Author's Affiliation
Other Contributor(s)
Abstract
Purpose: To investigate the efficacy and safety of selective intra-ophthalmic arterial combined nimodipine and alteplase infusion in patients with central retinal artery occlusion (CRAO). Design: Non-randomized, prospective interventional study. Methods: All patients with CRAO who presented at our institute within 24 hours from CRAO onset from August 2020 to July 2022 were included. Intra-arterial nimodipine and alteplase were given selectively into the ophthalmic artery. Visual acuity was recorded during and after the procedure. Change in best corrected visual acuity (BCVA) 1 month post-treatment, relative to baseline, was set as the primary outcome measure. Significant improvement in vision and adverse events are reported as secondary outcomes. Patients: Nine patients with non-arteritic CRAO were enrolled. Results: A total of nine patients with CRAO underwent selective intra-ophthalmic arterial nimodipine and alteplase injection. Overall, BCVA had statistically significantly improved by 0.78 logarithm of the minimum angle of resolution (logMAR) at 1 month compared with baseline (95% confidence interval: (−1.24, −0.31), p-value = 0.001). Seven (77.8%) patients had significant visual improvement (≥0.3 logMAR) at 1-month post-treatment. There were minor adverse events during administration of the nimodipine, including chemosis and headache, which resolved after the discontinuation of nimodipine. There were also asymptomatic thromboembolic events in 2 patients (22.2%) after the intervention procedure, without any morbidity or mortality. Conclusion: The use of selective intra-ophthalmic arterial combined nimodipine and alteplase was efficacious in improving BCVA at 1 month for patients with non-arteritic CRAO presenting between 24 hours from onset, with minor adverse events but no serious adverse events.