gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

Multicenter study of the european assessment group for lysis in the eye (EAGLE-Group) for the treatment of central retinal artery occlusion (CRAO): lysis compared to non-invasive therapy

Meeting Abstract

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogSA.13.11

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dog2004/04dog392.shtml

Published: September 22, 2004

© 2004 The EAGLE-Study Group.
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Outline

Text

Objective

The natural course of central retinal artery occlusion (CRAO) often leads to legal blindness in the affected eye. To date, none of the non-invasive therapies could prove efficiacy in retrospective studies. In 1991 a new invasive therapy was started in patients with an acute CRAO. This therapy is the local and intraarterial fibrinolysis. The treatment is comparable to the invasive therapy in patients with an acute ischemic stroke. In pilot studies, this therapy was superior to the non-invasive treatments.

Methods

To evaludate the therapeutical efficiacy we started a prospective and randomized multicenter study in 2002. To date 14 medical centers in germany, switzerland and austria are involved in the study. Another 4 centers will join the study soon.

Inclusion criterias are:

- age between 18 - 75 years

- CRAO not older than 20 hours

- visual acuity < 0.32

The most important exclusion criterias are CRAO older than 20 hours, branch retinal artery occlusion (BRAO), cilioretinal arteries supplying the macula and profound general diseases.

After randomisation the patient will either be treated by non-invasive or by lysis therapy. The non-invasive regime includes bulbus massage, lowering of the intraocular pressure with eye drops (timolol R) and acetacolamide, acetylsalicyl acid, heparin and depending on the haematocrit an isovolaemic haemodilution. In case of local intraarterial fibrinolysis a maximum of 50µm rtPA will be injected into the ophthalmic artery by the neuroradiologists.

During the following 4 days all patients will be treated with heparin.

Primary study endpoint is the visual acuity before and 1 month after therapy.