Minimal invasive therapie bei klinisch komplettem zentralarterienverschluss - Eigene ergebnisse und literaturvergleich

Background: Goal of our study was the comparison of the efficacy of various minimal invasive therapeutic regimens for clinically complete central retinal artery occlusion (CRAO) and the comparison with the literature. Patients and methods: In a retrospective study 93 patients treated for CRAO during the period 1994-1998 were identified. 65 of these patients with clinically complete occlusion without a cilioretinal artery were included in the study. Analysis focused on the results of different therapies and the duration of visual impairment till starting treatment. Results: The following therapies were used: acetazolamide (65%), aspirin (60%), bulbus massage (45%), hemodilution (34%), oral pentoxifylline (28%), topical beta blockers (9%), paracentesis (8%), heparin (6%). In 15% of all cases an improvement of at least 3 visual acuity gradations was achieved. No significant positive influence of any treatment method could be identified. Also, a correlation between duration of visual impairment and final visual acuity could not be shown. In the literature very different criteria for inclusion of patients to the studies and for visual acuity improvement are found. When applying comparable criteria to ours most studies show similar results for the therapies listed above as well as for paracentesis and the use of carbogen (95% O₂ and 5% CO₂). Conclusion: The minimal invasive treatments given above do only improve natural course of CRAO in occasional cases. Thus a therapy (-combination) should be chosen, which is adapted to the individual risk factors and is exposing the patient to a low risk by therapy itself.