{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T02:46:23Z","timestamp":1788921983996,"version":"build-2803163510"},"reference-count":31,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T00:00:00Z","timestamp":1661126400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Treatment of non-arteritic central retinal artery occlusion is still inconsistent. Therefore, the current study aimed to evaluate the efficacy of intravenous thrombolysis (IVT) and describe the prevalence of co-occurring ischemic brain lesions in patients with acute visual loss due to ischemia. Methods: We analysed 38 consecutive patients with acute visual loss between January 2015 and June 2020. Patients presenting within 4.5 h of symptom onset without any contraindication were treated with IVT. Patients underwent neurologic and ophthalmologic examination and diagnostic workup for the underlying aetiology. Follow-up was performed after 3 and 12 months. Results: Patients treated with IVT had a significantly better functional outcome at discharge compared to patients treated conservatively. No additional ischemic brain lesions were detected (0 of 38). Three patients had extracranial carotid artery stenosis \u226550%. Atrial fibrillation was present in four patients, three of whom already received oral anticoagulation. In the remaining 31 patients no embolic source was detected. However, the number of plaques were rated mild to moderate. Within three months, one patient developed transient visual loss while another suffered a contralateral transient ischemic attack. Conclusions: IVT may represent a safe and effective treatment option in patients with isolated visual loss due to ischemia. The aetiology was atherosclerotic burden rather than embolism caused by carotid stenosis or atrial fibrillation, bringing the current diagnostic procedure and therapy into question. Randomized trials are necessary to evaluate the efficacy and safety of IV thrombolysis and clarify the aetiology of isolated visual loss due to ischemia.<\/jats:p>","DOI":"10.3390\/life12081279","type":"journal-article","created":{"date-parts":[[2022,8,22]],"date-time":"2022-08-22T01:56:40Z","timestamp":1661133400000},"page":"1279","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Retinal Infarction: A Pilot Study on the Efficacy and Safety of Intravenous Thrombolysis and Underlying Aetiologies"],"prefix":"10.3390","volume":"12","author":[{"given":"Sonja","family":"Sch\u00f6necker","sequence":"first","affiliation":[{"name":"Department of Neurology, Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, LMU, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes","family":"Wischmann","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, LMU, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis C.","family":"Thunstedt","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, LMU, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Feil","sequence":"additional","affiliation":[{"name":"Department of Neurology & Stroke, Eberhard-Karls University, 72074 T\u00fcbingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4473-2812","authenticated-orcid":false,"given":"Marc J.","family":"Mackert","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, LMU, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siegfried","family":"Priglinger","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, LMU, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4967-8336","authenticated-orcid":false,"given":"Lars","family":"Kellert","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ludwig-Maximilians-Universit\u00e4t M\u00fcnchen, LMU, 81377 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,8,22]]},"reference":[{"key":"ref_1","first-page":"136","article-title":"Ueber Embolie der Arteria centralis retinae als Ursache pl\u00f6tzlicher Erblindung","volume":"5","year":"1859","journal-title":"Arch. Ophthalmol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"688","DOI":"10.1038\/eye.2013.25","article-title":"A review of central retinal artery occlusion: Clinical presentation and management","volume":"27","author":"Varma","year":"2013","journal-title":"Eye"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1016\/j.ajo.2011.05.005","article-title":"The incidence of central retinal artery occlusion in Olmsted County, Minnesota","volume":"152","author":"Leavitt","year":"2011","journal-title":"Am. J. Ophthalmol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"490","DOI":"10.1007\/s10384-004-0102-y","article-title":"Visual outcome in central retinal and branch retinal artery occlusion","volume":"48","author":"Yuzurihara","year":"2004","journal-title":"Jpn. J. Ophthalmol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1933","DOI":"10.1016\/j.ophtha.2014.04.029","article-title":"Nationwide incidence of clinically diagnosed central retinal artery occlusion in Korea, 2008 to 2011","volume":"121","author":"Park","year":"2014","journal-title":"Ophthalmology"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1684","DOI":"10.4103\/ijo.IJO_1446_18","article-title":"Central retinal artery occlusion","volume":"66","author":"Hayreh","year":"2018","journal-title":"Indian J. Ophthalmol."},{"key":"ref_7","doi-asserted-by":"crossref","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":"ref_8","doi-asserted-by":"crossref","first-page":"1881","DOI":"10.1016\/j.ophtha.2015.05.044","article-title":"Cardiovascular Risk Factors in Central Retinal Artery Occlusion: Results of a Prospective and Standardized Medical Examination","volume":"122","author":"Callizo","year":"2015","journal-title":"Ophthalmology"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.1111\/jth.12297","article-title":"Retinal vein and artery occlusions: A risk factor for stroke in atrial fibrillation","volume":"11","author":"Christiansen","year":"2013","journal-title":"J. Thromb. Haemost."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1016\/j.ajo.2018.08.027","article-title":"Stroke Risk and Risk Factors in Patients with Central Retinal Artery Occlusion","volume":"196","author":"Lavin","year":"2018","journal-title":"Am. J. Ophthalmol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1080\/02713683.2019.1641826","article-title":"Prevalence of Atrial Fibrillation in Patients with Retinal Vessel Occlusion and Its Association: A Systematic Review and Meta-Analysis","volume":"44","author":"Kewcharoen","year":"2019","journal-title":"Curr. Eye Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"P120","DOI":"10.1016\/j.ophtha.2016.09.024","article-title":"Retinal and Ophthalmic Artery Occlusions Preferred Practice Pattern\u00ae","volume":"124","author":"Olsen","year":"2017","journal-title":"Ophthalmology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1016\/j.ajo.2005.03.038","article-title":"Central retinal artery occlusion: Visual outcome","volume":"140","author":"Hayreh","year":"2005","journal-title":"Am. J. Ophthalmol."},{"key":"ref_14","doi-asserted-by":"crossref","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":"ref_15","first-page":"Cd001989","article-title":"Interventions for acute non-arteritic central retinal artery occlusion","volume":"2009","author":"Fraser","year":"2009","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2489","DOI":"10.2147\/OPTH.S232560","article-title":"Intra-Arterial Thrombolysis for Central Retinal Artery Occlusion","volume":"13","author":"Hakim","year":"2019","journal-title":"Clin. Ophthalmol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"76","DOI":"10.3389\/fneur.2018.00076","article-title":"Intra-Arterial Thrombolysis for Acute Central Retinal Artery Occlusion: A Systematic Review and Meta-Analysis","volume":"9","author":"Page","year":"2018","journal-title":"Front. Neurol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2018","DOI":"10.1161\/STROKEAHA.119.028743","article-title":"Intravenous Fibrinolysis for Central Retinal Artery Occlusion: A Cohort Study and Updated Patient-Level Meta-Analysis","volume":"51","author":"Nackenoff","year":"2020","journal-title":"Stroke"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1161\/01.STR.19.5.604","article-title":"Interobserver agreement for the assessment of handicap in stroke patients","volume":"19","author":"Koudstaal","year":"1988","journal-title":"Stroke"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2322","DOI":"10.1161\/STROKEAHA.115.009839","article-title":"Retrobulbar Spot Sign Predicts Thrombolytic Treatment Effects and Etiology in Central Retinal Artery Occlusion","volume":"46","author":"Nedelmann","year":"2015","journal-title":"Stroke"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1177\/1747493016687578","article-title":"Management of acute central retinal artery occlusion: Intravenous thrombolysis is feasible and safe","volume":"12","author":"Godeneche","year":"2017","journal-title":"Int. J. Stroke"},{"key":"ref_22","first-page":"e282","article-title":"Management of Central Retinal Artery Occlusion: A Scientific Statement from the American Heart Association","volume":"52","author":"Schrag","year":"2021","journal-title":"Stroke"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"2156","DOI":"10.1016\/j.jstrokecerebrovasdis.2014.04.008","article-title":"Intravenously administered tissue plasminogen activator useful in milder strokes? A meta-analysis","volume":"23","author":"Yeo","year":"2014","journal-title":"J. Stroke Cerebrovasc. Dis."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"2117","DOI":"10.12659\/MSM.892259","article-title":"Safety and outcome of thrombolysis in mild stroke: A meta-analysis","volume":"20","author":"Shi","year":"2014","journal-title":"Med. Sci. Monit."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1159\/000185607","article-title":"Safety and outcome after thrombolysis in stroke patients with mild symptoms","volume":"27","author":"Nowe","year":"2009","journal-title":"Cerebrovasc. Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1016\/j.ajo.2014.01.033","article-title":"Co-occurrence of acute retinal artery occlusion and acute ischemic stroke: Diffusion-weighted magnetic resonance imaging study","volume":"157","author":"Lee","year":"2014","journal-title":"Am. J. Ophthalmol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1002\/ana.23597","article-title":"Concurrent acute brain infarcts in patients with monocular visual loss","volume":"72","author":"Helenius","year":"2012","journal-title":"Ann. Neurol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1928","DOI":"10.1016\/j.ophtha.2009.03.006","article-title":"Retinal artery occlusion: Associated systemic and ophthalmic abnormalities","volume":"116","author":"Hayreh","year":"2009","journal-title":"Ophthalmology"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"53","DOI":"10.3341\/kjo.2009.23.1.53","article-title":"Two cases of branch retinal arterial occlusion after carotid artery stenting in the carotid stenosis","volume":"23","author":"Lee","year":"2009","journal-title":"Korean J. Ophthalmol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"326","DOI":"10.7461\/jcen.2013.15.4.326","article-title":"Ophthalmic artery occlusion after carotid revascularization","volume":"15","author":"Yi","year":"2013","journal-title":"J. Cerebrovasc. Endovasc. Neurosurg."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1097\/01.wno.0000189065.20552.88","article-title":"Carotid endarterectomy for ophthalmic manifestations: Is it ever indicated?","volume":"25","author":"Wolintz","year":"2005","journal-title":"J. Neuroophthalmol."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/12\/8\/1279\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:13:21Z","timestamp":1760141601000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/12\/8\/1279"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,22]]},"references-count":31,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8]]}},"alternative-id":["life12081279"],"URL":"https:\/\/doi.org\/10.3390\/life12081279","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,22]]}}}