PURPOSE: To report the efficacy of an aggressive systematic regimen for the treatment of acute @entity732 ( @entity732 ). METHODS: Eleven @entity1 who had unilateral @entity732 with symptoms of fewer than 48 hours' duration were treated with an aggressive stepwise systematic regimen until retinal circulation improved or until all the treatment steps were performed. Five @entity1 with unilateral @entity732 and symptoms of fewer than 48 hours' duration were treated in the same institution in an arbitrary nonsystematic manner. The therapeutic steps of the aggressive treatment included ocular massage, sublingual @entity3763 , intravenous @entity3791 , intravenous @entity2656 or oral @entity653 , anterior chamber paracentesis, intravenous @entity1667 followed by streptokinase, and retrobulbar @entity6116 . After each step, retinal flow was evaluated by three-mirror contact lens. The nonsystematic treatment was arbitrary and included one or several of the above. Visual acuity and complete eye examination data were recorded before and after treatment. RESULTS: Visual acuity and retinal arterial supply were improved in eight (73%) of the 11 @entity1 treated in the stepwise systematic manner. All eight @entity1 in whom visual acuity improved had symptoms for fewer than 12 hours, and the presumed cause was either platelet-derived or @entity165 embolus from @entity1856 or the @entity1 had @entity726 . @entity1 in whom visual acuity did not improve had @entity732 that was attributed to calcified emboli or primary @entity1701 and had symptoms more than 12 hours before treatment. Visual acuity did not improve in all five @entity1 with the nonsystematic treatment regardless of the presumed cause or duration of the occlusion. The success of the treatment in the systematic treatment group was statistically significantly better compared with the outcome of the nonsystematic treated group (Fischer exact test, P = .01). CONCLUSIONS: In the treatment of @entity732 , an aggressive systematic regimen including medical and mechanical means may reestablish retinal circulation and improve visual outcome. The cause of @entity432 , the nature of occlusive emboli, and the duration of @entity2479 may determine the visual outcome, but a larger series is warranted to verify the effectiveness of the treatment and the prognostic factors.

Aggressive systematic treatment for XXXX .

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity2656 :: ('MESH:D008353', 'Chemical') :: ['mannitol'] @entity1667 :: ('MESH:D008775', 'Chemical') :: ['methylprednisolone'] @entity3763 :: ('MESH:D007548', 'Chemical') :: ['isosorbide dinitrate'] @entity2479 :: ('MESH:D012173', 'Disease') :: ['retinal ischemia'] @entity3791 :: ('MESH:D000086', 'Chemical') :: ['acetazolamide'] @entity6116 :: ('MESH:D014043', 'Chemical') :: ['tolazoline'] @entity726 :: ('MESH:D005901', 'Disease') :: ['glaucoma'] @entity653 :: ('MESH:D005990', 'Chemical') :: ['glycerol'] @entity1701 :: ('MESH:D016736', 'Disease') :: ['antiphospholipid antibody syndrome'] @entity432 :: ('MESH:D001157', 'Disease') :: ['arterial occlusion'] @entity1856 :: ('MESH:D058226', 'Disease') :: ['atheroma'] @entity732 :: ('MESH:D015356', 'Disease') :: ['nonarteritic central retinal artery occlusion', 'CRAO'] @entity165 :: ('MESH:D002784', 'Chemical') :: ['cholesterol']
@entity732 :: (MESH:D015356,Disease) :: ['central retinal artery occlusion']
