The time factor might have saved Jablonski's eyesight in April 2001. The Ellicott City resident, now 68, was on her way to the dry cleaners when she realized she had something far more serious than a speck of mascara in her eye. She called her husband, who took her to Hopkins.
There, doctors from Wilmer stuck a needle in her eye to relieve the pressure but told her there was no way to save her eyesight.
"I never thought this would happen to me," said Jablonski, a retired nurse. "I'm not overweight. I eat well. I exercise."
But her daughter, Dr. Donna Perlin, who was working a shift in Hopkins' pediatric emergency room, asked doctors about TPA treatment. They called Aldrich and the Brain Attack Team.
"I asked a doctor on the team, 'What would you do if it were your mother?' " said Perlin, now 44 and a pediatric emergency medicine physician at Vanderbilt University in Nashville.
"And he said, 'I would go for it.' So we went for it."
Within 10 hours of losing vision, Jablonski was receiving TPA treatment. Afterward, she recovered in the hospital for several days and left with 20/40 vision - her original eyesight.
"The procedure was very traumatic, and I didn't know whether I would throw another clot," Jablonski said. "But I recovered very quickly and am so grateful to the doctors."
Others in the Hopkins study weren't so fortunate: Five out of 21 patients who received TPA saw no improvement and remained essentially blind in one eye. Researchers speculate that patients who received TPA later or already suffered from extensive arteriosclerosis (hardening of the arteries) did not respond as well.
Some doctors also caution that the procedure poses its own dangers -including stroke and heart attack - since the catheter works its way through major arteries. "Not all institutions can offer this therapy. They would need very well-trained interventionalists," Miller said. "But the risks are decreased in experienced hands."
One ophthalmologist who wasn't involved in the study called it well-designed and informative. But he wouldn't recommend the treatment with absolute confidence.
"There's no definitive conclusion from the study," said Dr. George Williams, a spokesman for the American Academy of Ophthalmology and chairman of the department of ophthalmology at Beaumont Hospital in Royal Oak, Mich. "The data, although promising, warrants further investigation."
