Intravenous tenecteplase not recommended for central retinal artery occlusion (Aspirin instead)

Medical Xpress / HealthDay / New England Journal of Medicine ^ | Feb. 2, 2026 | Elana Gotkine / Stephen J. Ryan et al

[ConservativeMind]

Intravenous tenecteplase administered within 4.5 hours after onset of central retinal artery occlusion does not improve vision recovery at 30 days compared with oral aspirin, according to a study.

Stephen J. Ryan, M.D. and colleagues conducted a phase 3, randomized, controlled trial involving adults with acute, nonarteritic central retinal artery occlusion who had symptom onset within 4.5 hours before treatment. Patients at 16 sites in six countries were randomly assigned to receive intravenous tenecteplase and oral placebo or intravenous placebo and oral aspirin (40 and 38 individuals, respectively). Vision recovery was assessed as the primary end point, defined as a best corrected visual acuity (BCVA) in the affected eye of up to 0.7 logMAR at 30 days.

The researchers found that 20% and 24% of patients in the tenecteplase and aspirin groups, respectively, had vision recovery at 30 days (risk difference, −3.7 percentage points; 95% confidence interval, −22.0 to 14.7; P = 0.69). With regard to secondary visual end points of a BCVA of up to 0.5 logMAR, mean improvement in BCVA, and perimetry score at 30 days, no substantial difference was seen between the groups. A greater incidence of adverse events was seen in the tenecteplase group, including one fatal intracranial hemorrhage.

"These findings do not support the routine use of thrombolytic therapy to treat central retinal artery occlusion," the authors write.

[ConservativeMind]

Oral aspirin is better than the normally injected drug for central retinal artery occlusion.

[ConservativeMind]

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[Mark]

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[Cold Heart]

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[sauropod]

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[telescope115]

I have, along with my glaucoma, two branch retinal occlusions in my right eye. It would be interesting to see if a similar study had been conducted with patients with these.

[ConservativeMind]

Have you looked at the supplements to help with glaucoma, from study write ups I've posted?

—Mirtogenol and black currant extract for eye pressure
—Agmatine Sulfate and Thiamine for aqueous humor flow/eye pressure
—Glutamine and tea (seemingly black) for retinal thickness

There are a few other items that could be helpful, but these are things I found to be helpful.

[telescope115]

I haven’t seen those. I am getting an injection every eight weeks and taking Areds 2 multivitamins. The occlusions caused an “eye stroke”. Intervention is keeping it from getting worse.

[ConservativeMind]

Is your eye pressure in a good range, with medicine?

[ConservativeMind]

Eating goji berries will really up your zeaxanthin intake.

[telescope115]

Thanks, I’ll see if I can find them .

[AppyPappy]

If you smoke Weed, you won’t care.

[telescope115]

Is your eye pressure in a good range, with medicine?

Yes it is, I forget what what it is but they tell me it’s doing great. I do have a little vision loss from the occlusion, that’s not coming back, but at least it’s not getting any worse.

Renewed my driver’s license last week and passed the eye test. I was a little worried about that.