He said he would prefer randomized trials with more patients but acknowledged the difficulty in managing such trials, given the rarity of the condition.
"We have one of the busiest hospitals in the U.S., and it took seven years to get 42 patients," Williams said of the Hopkins study.
Volunteers who arrived more than 15 hours after losing their vision were automatically given standard therapies instead of TPA. That might have skewed the results in favor of the experimental treatment, he said.
In addition, Williams said, he wanted to know more about exactly how well the patients could see before and after the operation - instead of the relative improvement in eyesight that Hopkins reported.
"If the alternative is total blindness, then 20/200 is a great result," he said. "But if patients are initially presenting with better vision than that, then is that enough improvement to justify the expense and the risk of the procedure?"
For their part, Hopkins researchers said their main concern was improvement in vision - they will address specific visual acuity the next time around. Their next step is controlled, randomized, multicenter trials to confirm their initial success and address the safety of the treatment.
For patients, they say, the most important message from the report is recognizing the warning signs of an eye stroke.
"If you lose vision abruptly, you need to go to the ER right away," Miller said. "Do not wait until the next day to see an ophthalmologist, because then it may be too late."
euna.lhee@baltsun.com
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