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Introduction: The diagnosis of acute central retinal artery occlusion (CRAO) is commonly delayed in emergency departments (ED) where ophthalmologists are rarely available for immediate consultation. Thrombolysis is sometimes given empirically for presumed CRAO without confirmation of the diagnosis with ocular funduscopic examination.
Methods: We describe one case of severe intraocular hemorrhage following intravenous thrombolysis for a retinal detachment misdiagnosed as a CRAO, and two cases of worsening intraocular hemorrhage following intravenous thrombolysis for misdiagnosed CRAO, and review the literature.
Results: We identified 4 cases in the literature were thrombolysis given for RAO resulted in ocular hemorrhage. We identified 12 additional cases where thrombolysis given for any indication resulted in intraocular hemorrhage.
Discussion: Ocular hemorrhage is a rare but potentially devastating complication of thrombolysis in patients with underlying retinal disorders other than CRAO. Thrombolysis should never be given for acute vision loss without a funduscopic examination or ocular imaging confirming the diagnosis of CRAO.
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http://dx.doi.org/10.3389/fneur.2025.1631546 | DOI Listing |
Ophthalmol Glaucoma
September 2025
NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, England; Discipline of Clinical Ophthalmology and Eye Health, University of Sydney, Sydney, New South Wales, Australia.
Purpose: To compare the long-term safety of MicroShunt implantation with trabeculectomy in eyes with primary open-angle glaucoma (POAG).
Methods: This was a 3-year observational extension of a 2-year prospective randomized trial comparing clinical outcomes of MicroShunt implantation with trabeculectomy, both augmented with mitomycin C. Adverse events (AEs), intraocular pressure (IOP), and IOP-lowering medication use were recorded 36, 48, and 60 months after initial randomization.
Cureus
August 2025
Department of Ophthalmology, Tsurumi University School of Dental Medicine, Yokohama, JPN.
Traumatic vitreous hemorrhage is most commonly associated with sports injuries or accidental falls. We report an exceptionally rare case of vitreous hemorrhage presumed to result from blunt trauma inflicted by the forepaw of a domestic cat. A 50-year-old man presented with blurred vision and ocular pain in his right eye after being struck by his pet cat.
View Article and Find Full Text PDFFront Neurol
August 2025
Department of Ophthalmology, Emory University School of Medicine, Atlanta, GA, United States.
Introduction: The diagnosis of acute central retinal artery occlusion (CRAO) is commonly delayed in emergency departments (ED) where ophthalmologists are rarely available for immediate consultation. Thrombolysis is sometimes given empirically for presumed CRAO without confirmation of the diagnosis with ocular funduscopic examination.
Methods: We describe one case of severe intraocular hemorrhage following intravenous thrombolysis for a retinal detachment misdiagnosed as a CRAO, and two cases of worsening intraocular hemorrhage following intravenous thrombolysis for misdiagnosed CRAO, and review the literature.
BMJ Case Rep
September 2025
Neurology, Father Muller Medical College, Mangalore, Karnataka, India.
A man in his 30s presented with sudden vision loss in the right eye and diminished vision in the left eye accompanied by headache. Clinical findings included bilateral disc oedema, reduced visual acuity in both eyes (right eye>left eye), dense premacular haemorrhage in the right eye and impaired colour vision. Blood tests were positive for serum myelin oligodendrocyte glycoprotein (MOG) antibodies, confirming MOG-associated optic neuritis (ON).
View Article and Find Full Text PDFBMJ Case Rep
September 2025
Manchester Royal Eye Hospital, Manchester, UK.
We report a case of a young woman who presented with a vitreous haemorrhage associated with a combined hamartoma of the retina and retinal pigment epithelium (CHRRPE). During her clinical course, while the vitreous haemorrhage resolved, the lesion enlarged with a worsening epiretinal membrane. The patient's visual acuity reduced from 0.
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