Changes of Visual Field Defects After IAT for CRAO

Central retinal artery occlusion (CRAO) is an ophthalmic emergency which leads to devastating visual function defects and poor prognosis. Though traditional conservative treatments are widely used, none of them is proved to be effective. A number of meta-analyses and observational studies indicate intravenous thrombolysis to be beneficial in CRAO. Selective intra-arterial thrombolysis (IAT) introducing rt-PA directly into the ophthalmic circulation by super-selective microcatheterization may reduce the complications such as intracranial and systemic hemorrhage. The residual visual field is significant for patients with CRAO who have poor central visual acuity. Thus, it is clinically significant to study the changes in visual fields in eyes with CRAO.

Inclusion Criteria:1. Non-arteritic CRAO with symptom duration ≤7d 2. Age from 18 years old between 80 years old 3. Qualified systemic conditions, well-controlled blood pressure, well-controlled blood glucose, qualified liver and kidney function, no allergic history to contrast agent or rt-PA.Exclusion Criteria:Ocular factor or diseaseBranch retinal artery occlusionCombined retinal vein occlusionSuspicious ocular ischemic syndrome, such as ophthalmic artery occlusion or carotid artery occlusionExisted retinal problems decreasing visual function, such as macular disease, severe nonproliferative or proliferative diabetic retinopathy, severe cataract or glaucomaCentral retinal artery occlusion from iatrogenic causeHistory of thrombolysis for CRAO or CRVOSystemic factors restricting thrombolysisUncontrolled hypertension (systolic blood pressure > 180mmHg ); Uncontrolled hyperglycemia (fasting blood glucose > 9mmol/L);Coagulation disorderHistory of intracranial hemorrhage, heart attack, cerebral infarction, or intracranial surgery within 3 moCurrent antithrombotic treatmentHistory of allergic reaction to contrast agent or rt-PA