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Abstract Details

Intravenous and Intra-arterial Thrombolysis for Retinal Artery Occlusion
Neuro-ophthalmology/Neuro-otology
P4 - Poster Session 4 (8:00 AM-9:00 AM)
17-006
To describe patient demographics, clinical characteristics, and treatment of patients diagnosed with acute retinal artery occlusion (RAO). 
RAO, a painless ocular ischemic stroke, causes sudden, often severe vision loss. With limited treatment options, the American Heart Association (AHA) recommends intravenous thrombolysis (IVT) within 4.5 hours or intra-arterial thrombolysis (IAT) within 6.5 hours of symptom onset.  
This retrospective study reviewed adult patients diagnosed with acute RAO from 2012 to September 2025 at a comprehensive stroke center. Patients with acute RAO were eligible for IVT within 4.5 hours or for IAT within 6.5 hours of symptom onset. Diagnosis was confirmed by ophthalmologic examination, and alternative causes were excluded. Summary data are reported. 
Fifty-three patients met inclusion criteria (35.8% branch RAO, 64.2% central RAO). Average age was 70.8+12.8 years;  64.2% were male. Hypertension was present in 80% and hyperlipidemia in 59%. Most (85%) presented outside the treatment window (range: 5 hours to three weeks), had unknown time of onset, or were on DOAC. Among eight treated, average time from symptom onset to diagnosis was 2.2+1.1 hours, and to treatment was 3.5+0.9 hours. Treatment included IV tPA (50.0%), IA tPA (25.0%), both IV tPA and IA tPA (12.5%), and IV TNK (12.5%). CTA showed significant ipsilateral carotid stenosis in 28.3%. Atrial fibrillation was present in 22.6%, with one new diagnosis. 
This retrospective analysis of patients with acute retinal artery occlusion (RAO) reveals that the majority presented outside the therapeutic window, significantly limiting eligibility for intervention.  Along with a small subset who received treatment-via intravenous or intra-arterial thrombolysis-diagnosis and management were achieved promptly, with treatment initiated with an average of 3.5 hours from symptom onset.  These findings emphasized the critical need for heightened awareness, early recognition, and rapid triage to expand treatment opportunities and improve outcomes in acute RAO. 
Authors/Disclosures
Jason T. Schick, DO (Trinity Health Grand Rapids)
PRESENTER 		Dr. Schick has nothing to disclose.
Saad Umar Mr. Umar has nothing to disclose.
Carlos R. Santos An immediate family member of Mr. Santos has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Cochrane. An immediate family member of Mr. Santos has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Giarmarco, Mullins & Horton PC. The institution of an immediate family member of Mr. Santos has received research support from Saint Mary's Foundation. An immediate family member of Mr. Santos has received research support from 好色先生.
Emily Salacina, RN Ms. Salacina has nothing to disclose.
Muhammad Farooq, MD (Neuroscience Program,Saint Mary'S Health) Dr. Farooq has nothing to disclose.
Jose R. Santos, MD (Trinity Health Saint Mary's) An immediate family member of Dr. Santos has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Cochrane. Dr. Santos has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Giarmarco, Mullins & Horton PC. Dr. Santos has or had stock in Gilead Sciences.Dr. Santos has or had stock in Novocure.Dr. Santos has or had stock in Shockwave Medical.Dr. Santos has or had stock in Teva. An immediate family member of Dr. Santos has received research support from 好色先生. The institution of an immediate family member of Dr. Santos has received research support from Trinity Health Saint Mary's Foundation. An immediate family member of Dr. Santos has a non-compensated relationship as a Delegate with AAN Neurology on the Hill that is relevant to AAN interests or activities. An immediate family member of Dr. Santos has a non-compensated relationship as a Participant with AAN Palatucci Advocacy Leadership Forum that is relevant to AAN interests or activities. An immediate family member of Dr. Santos has a non-compensated relationship as a Scholar with AAN Health Equity Symposium Scholarship that is relevant to AAN interests or activities. An immediate family member of Dr. Santos has a non-compensated relationship as a Participant with AAN Emerging Leaders Program that is relevant to AAN interests or activities.
Aileen Antonio, MD, FAAN (Trinity Health Saint Mary's Hauenstein Neurosciences) Dr. Antonio has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Cochrane. An immediate family member of Dr. Antonio has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Giamarco, Mullins & Horton PC. The institution of Dr. Antonio has received research support from Saint Mary's Foundation. Dr. Antonio has received research support from 好色先生.