Intra-Arterial Thrombolysis for Central Retinal Artery Occlusion in United States: Nationwide In-Patient Survey 2001-2003

Abstract

Intra-arterial thrombolysis (IAT) has been used as a treatment modality for central retinal artery occlusion (CRAO). However, national estimates of such practice and associated outcomes are not available. We performed this study to determine the frequency and outcomes of thrombolysis among adult patients hospitalized in United States (US) for CRAO. We determined the rates, hospital outcomes, and hospital charges incurred for patients with CRAO treated with thrombolysis using Nationwide Inpatient Survey (NIS) and compared them with patients treated without thrombolysis. NIS is the largest all-payer inpatient care database in the US approximating a 20-percent stratified sample of US community hospitals. There were 1379 admissions for primary diagnosis of CRAO in 2001-2003. IAT was used in 27(1.9%) of the patients with CRAO. There was no in-hospital mortality or intracranial hemorrhage reported among any patient with CRAO treated with thrombolysis. All patients treated with IAT were discharged home. IAT was exclusively used in urban-teaching hospitals. There is potential of benefit from IAT in CRAO, which is only offered in certain centers. Clinical trials are needed to demonstrate this beneficial effect.