{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T06:09:50Z","timestamp":1785305390522,"version":"3.55.0"},"reference-count":17,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the efficacy and safety of low-dose urokinase combined with papaverin administered via superselective ophthalmic artery thrombolysis in patients with non-arteritic central retinal artery occlusion (CRAO).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on the clinical data of 20 CRAO patients who underwent ophthalmic artery thrombolysis at our hospital between December 2023 and July 2025. All procedures were performed under local anesthesia via femoral artery puncture and catheterization. A sequential injection of 400,000 IU urokinase followed by 30\u202fmg papaverine was administered into the ophthalmic artery. Best-corrected visual acuity (BCVA, expressed in logMAR) was assessed pre- and post-operatively, and adverse events were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median time from symptom onset to treatment was 7.25\u202fh (IQR: 2.00\u201320.50). The mean preoperative BCVA in the affected eye was 2.38\u202f\u00b1\u202f0.93 logMAR, which significantly improved to 0.33\u202f\u00b1\u202f0.26 logMAR postoperatively (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). The median improvement in BCVA was 2.54 logMAR units (IQR: 0.84\u20132.78). Although a statistically significant difference persisted between the postoperative visual acuity of the affected eye and that of the contralateral healthy eye (0.28\u202f\u00b1\u202f0.26 logMAR) (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.002), the median difference was only 0.075 logMAR, suggesting limited clinical significance. No serious adverse events, such as hemorrhage or cerebral infarction, occurred in any patient.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Low-dose urokinase combined with papaverine via ophthalmic artery thrombolysis significantly improved visual acuity with a favorable safety profile in carefully selected CRAO patients, demonstrating potential for clinical application.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2025.1760868","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T05:44:53Z","timestamp":1768196693000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Low-dose urokinase thrombolysis combined with papaverine for central retinal artery occlusion: a preliminary exploration of efficacy and safety"],"prefix":"10.3389","volume":"16","author":[{"given":"Hongyan","family":"Sun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Geng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenchao","family":"Qiu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiahao","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengxin","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zengqiang","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenming","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingjiang","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianwei","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"P270","DOI":"10.1016\/j.ophtha.2024.12.024","article-title":"Retinal and ophthalmic artery occlusions preferred practice pattern","volume":"132","author":"Kovach","year":"2025","journal-title":"Ophthalmology"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1927","DOI":"10.1016\/S0140-6736(20)31559-2","article-title":"Retinal vascular occlusions","volume":"396","author":"Scott","year":"2020","journal-title":"Lancet"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"e282","DOI":"10.1161\/STR.0000000000000366","article-title":"Management of central retinal artery occlusion: a scientific statement from the American Heart Association","volume":"52","author":"Mac","year":"2021","journal-title":"Stroke"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1148","DOI":"10.1001\/jamaneurol.2015.1578","article-title":"Intravenous fibrinolytic therapy in central retinal artery occlusion: a patient-level meta-analysis","volume":"72","author":"Schrag","year":"2015","journal-title":"JAMA Neurol"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"7746","DOI":"10.1167\/iovs.13-12952","article-title":"Efficacy and safety of intra-arterial thrombolysis in central retinal artery occlusion","volume":"54","author":"Ahn","year":"2013","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"724","DOI":"10.1016\/j.ophtha.2023.11.031","article-title":"A remote consult retinal artery occlusion diagnostic protocol","volume":"131","author":"Lema","year":"2024","journal-title":"Ophthalmology"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"3175","DOI":"10.1161\/STROKEAHA.124.049955","article-title":"Early thrombolysis and outcomes in central retinal artery occlusion: an individual participant data meta-analysis","volume":"56","author":"Xie","year":"2025","journal-title":"Stroke"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1016\/j.oret.2023.12.007","article-title":"Central retinal artery occlusion: visual outcomes from a large northern California cohort","volume":"8","author":"Shah","year":"2024","journal-title":"Ophthalmol Retina"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"588","DOI":"10.1136\/bjo.2007.133488","article-title":"Intra-arterial thrombolysis for central retinal artery occlusion: a systematic review","volume":"92","author":"Noble","year":"2008","journal-title":"Br J Ophthalmol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"723","DOI":"10.1016\/s0014-4835(03)00214-8","article-title":"Central retinal artery occlusion. Retinal survival time","volume":"78","author":"Hayreh","year":"2004","journal-title":"Exp Eye Res"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1367","DOI":"10.1016\/j.ophtha.2010.03.061","article-title":"Central retinal artery occlusion: local intra-arterial fibrinolysis versus conservative treatment, a multicenter randomized trial","volume":"117","author":"Schumacher","year":"2010","journal-title":"Ophthalmology"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"2076","DOI":"10.1161\/01.STR.29.10.2076","article-title":"Selective intra-arterial fibrinolysis of acute central retinal artery occlusion","volume":"29","author":"Weber","year":"1998","journal-title":"Stroke"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"589","DOI":"10.1001\/jama.2024.23480","article-title":"Intra-arterial urokinase after endovascular reperfusion for acute ischemic stroke: the POST-UK randomized clinical trial","volume":"333","author":"Liu","year":"2025","journal-title":"JAMA"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"910","DOI":"10.1136\/bjo.57.12.910","article-title":"Effects of papaverine on the retinal microcirculation","volume":"57","author":"Ffytche","year":"1973","journal-title":"Br J Ophthalmol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1016\/j.survophthal.2019.01.011","article-title":"Central retinal artery occlusion-a new, provisional treatment approach","volume":"64","author":"Chronopoulos","year":"2019","journal-title":"Surv Ophthalmol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"842","DOI":"10.3760\/cma.j.cn112139-20250227-00096","article-title":"The application of superselective ophthalmic artery thrombolysis in the treatment of central retinal artery occlusion","volume":"63","author":"Yang","year":"2025","journal-title":"Zhonghua Wai Ke Za Zhi"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"1087","DOI":"10.1177\/23969873251314693","article-title":"European stroke organisation (ESO) guideline on visual impairment in stroke","volume":"10","author":"Rowe","year":"2025","journal-title":"Eur Stroke J"}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1760868\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T05:45:00Z","timestamp":1768196700000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2025.1760868\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,12]]},"references-count":17,"alternative-id":["10.3389\/fneur.2025.1760868"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2025.1760868","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,12]]},"article-number":"1760868"}}