Early Onset of Neovascular Glaucoma After Intra-Arterial Thrombolysis for Central Retinal Artery Occlusion: A Possible Complication?

Olga Furashova; Joerg Thalwitzer; Egbert Matthé

doi:10.2147/OPTH.S362019

Early Onset of Neovascular Glaucoma After Intra-Arterial Thrombolysis for Central Retinal Artery Occlusion: A Possible Complication?

Clin Ophthalmol. 2022 Apr 22:16:1235-1244. doi: 10.2147/OPTH.S362019. eCollection 2022.

Authors

Olga Furashova¹, Joerg Thalwitzer², Egbert Matthé³

Affiliations

¹ Department of Ophthalmology, Klinikum Chemnitz gGmbH, Chemnitz, Germany.
² Department of Neuroradiology, Klinikum Chemnitz gGmbH, Chemnitz, Germany.
³ Department of Ophthalmology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.

Abstract

Purpose: To report on four cases of central retinal artery occlusion (CRAO) treated with intra-arterial thrombolysis with early onset neovascular glaucoma in the further disease course.

Patients and methods: Retrospective analysis of the medical records of six consecutive patients treated with intra-arterial thrombolysis for CRAO of which four developed neovascular glaucoma.

Results: All six patients were diagnosed with acute CRAO and treated with intra-arterial thrombolysis 4.5-6 hours after symptom onset. The patients had no significant carotid artery stenosis and unremarkable ophthalmic history. No visual improvement could be achieved after treatment. Four to seven weeks after CRAO onset, four of these patients developed severe painful neovascular glaucoma.

Conclusion: Early onset of aggressive neovascular glaucoma following intra-arterial thrombolysis for CRAO might be a complication of CRAO itself, still possible association with intra-arterial thrombolysis in our patients should be discussed.

Keywords: intra-arterial thrombolysis; neovascular glaucoma; retinal artery occlusion.