TENecteplase in Central Retinal Artery Occlusion Stuy (TenCRAOS)

Exclusion Criteria

• •1. Other active intervention targeting CRAO.
• •2. Branch retinal artery occlusion, cilioretinal artery supplying the macula, combined arterial-venous occlusion, proliferative diabetic retinopathy, elevated intraocular pressure (\> 30 mmHg) or clinical suspicion of ophthalmic artery occlusion occlusion (e.g. choroidal nonperfusion, absence of cherry red spot, no light perception).
• •3. Systemic diseases; severe general diseases, systemic arterial hypertension (blood pressure \>185/110 mmHg), despite medical therapy, or clinical suspicion of acute systemic inflammation.
• •4. Presence of intracranial haemorrhage on brain MRI/CT.
• •5. Medical history: heart attack within the last 6 weeks, intracerebral bleeding or neurosurgical operation within the last 4 weeks, therapy with anticoagulation, allergic reaction to contrast agent, hemorrhagic diathesis, aneurysms, inflammatory vascular diseases (eg, giant cell arteritis, granulomatosis with polyangitis), endocarditis, or gastric ulcer.
• •6. No willingness and ability of the patient to participate in all follow-up examinations.
• •7. Pregnancy (if suspicion of pregnancy s-hCG or u-hCG must be negative).
• •8. Allergy or intolerance to any ingredients of IMP or placebo or gentamicin.
• •9. Other conditions / circumstances likely to lead to poor treatment adherence (eg, history of poor compliance, alcohol or drug dependency, no fixed abode).
• •10. Significant bleeding disorder either at present or within the past 6 months.
• •11. Effective oral anticoagulant treatment, eg, warfarin sodium (INR \>1.3).
• •12. Effective anticoagulant treatment with heparin or low molecular weight heparin the last 48 hours.
• •13. Any history of central nervous system damage (ie, neoplasm, aneurysm, intracranial or spinal surgery).
• •14. Known hemorrhagic diathesis.
• •15. Major surgery, biopsy of a parenchymal organ, or significant trauma within the past 2 months (this includes any trauma associated with acute myocardial infarction).
• •16. Recent non-compressible vessel puncture within 2 weeks.
• •17. Recent trauma to the head or cranium.
• •18. Prolonged cardiopulmonary resuscitation (\>2 minutes) within the past 2 weeks.
• •19. Acute pericarditis and/or subacute bacterial endocarditis.
• •20. Acute pancreatitis.
• •21. Severe hepatic dysfunction, including hepatic failure, cirrhosis, portal hypertension (oesophageal varices) and active hepatitis.
• •22. Active peptic ulceration.
• •23. Arterial aneurysm and known arterial/venous malformation.
• •24. Neoplasm with increased bleeding risk.
• •25. Any known history of hemorrhagic stroke or stroke of unknown origin.
• •26. Known history of ischemic stroke or transient ischemic attack in the preceding 3 months.
• •27. Dementia.