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목적 : To investigate the rate of Intraocular neovascularization following acute central retinal artery occlusion with or without (1) reperfusion and (2) intra-arterial thrombolysis and to prove the long-term benefit of IAT.
방법 : A retrospective review of electronic medical records of 153 consecutive patients with acute spontaneous non-arteritic CRAO who visited one tertiary hospital between January 2003 and December 2014 was performed. To evaluate changes in retinal blood flow, we repeated FA in intervals of one to three months until complete retinal arterial reperfusion was achieved. We divided the CRAO patient into reperfusion group or delayed perfusion group according to their follow-up FA.We compared anatomic outcomes (reperfusion status and incidence of ocular neovascularization) and analyzed risk factors .
결과 : The reperfusion rate evaluated by follow-up FA was greater in the IAT group than CST group during all the time period but statistical significance was observed only at 3 months and borderline significance was showed at 6 months since acute CRAO event. IAT (p = 0.01, HR=0.065) and delayed perfusion until 1 months (p = 0.032, HR=5.618), delayed perfusion until 3 months (p = 0.004, HR=7.548) were associated with occurrence of ONV.
결론 : CRAO could induce the chronic ischemic status in retina and the most important risk factor for developing ONV is a failure of arterial reperfusion. Despite of much argument, IAT may have a long-term anatomical benefit of reperfusion and ONV. Additionally, if the patients fail to achieve the restoration of blood supply evaluated by follow-up FA until several months, prophylactic PRP could be carefully considered.
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